家兔显微血管横断优先吻合动静脉选择的对比研究

目的采用家兔的股动静脉为模型进行血管吻合，探讨在断肢或断指时优先吻合动脉还是静脉通畅率更高，为临床外科医生在动静脉吻合优先选择上提供参考。方法将生理状况相同的健康幼龄家兔56只分为优先吻合股动脉（A组）与优先吻合股静脉（B组）2组，每组各28只。每只家兔切断股动脉和股静脉，血管断端暴露20min后再行血管端端吻合术；记录所用时间和针数；72h后观察血管通畅情况。结果A组中动静脉均通畅者16例；动脉通畅静脉不通畅8例；动静脉均不通畅者2例；术中致死2例；手术总用时间平均（51．21 8．46）min。B组中动静脉均通畅者22例；动脉通畅静脉不通畅者4例；动静脉都不通畅者2例；手术总用时平均（42．422．90）min。A组总通畅率是71．43％；动脉总通畅率是85．71％，静脉总通畅率是57．14％。B组总通畅率89．29％；动脉总通畅率是92．56％；静脉总通畅率是85．71％。B组静脉通畅率明显高于A组（P〈0．05）。结论无论动脉先吻合还是后吻合对动脉通畅率无影响，但是优先吻合静脉血管比后吻合静脉血管的静脉通畅率要高。本实验提示在断肢或断指手术时应优先吻合静脉，可以保证通畅率和血管吻合的质量。

Comparative study on anastomosis choice of microsurgical vascular in rabbits

Objective Use the femoral artery and vein of rabbits as a model for vascular anastomosis to discuss which patency rate is higher in the limbs or finger operation, and provide suggestions for clinical surgeons in operation. Methods 56 healthy young rabbits with the same physiological status wet equally divided into group A （anastomosed artery firstly） and group B （anastomosed vein firstly）. Cut the femoral artePy and femoral vein, and start the anastomosis vascular after exposured the broken ends of vessel for 20 minutes. Record the time and number of needles it used, and observe the rate of vascular patency after 72 hours. Results In group A, there were 16 cases with both artery and vein smooth, 8 cases with artery smooth while vein thrombosis, 2 cases with both artery and vein thrombosis, and 2 cases died during operation. The total time of operation were （51.21 _＋ 8.46） rain on average. In group B, 22 cases were of pateney both in artery and vein, 4 cases were of patency only in artery, and 2 cases were of no patency both in artery and vein. The total time of operation were （42.42 _＋2.90） rain on average. In group A, the total patency rate was 71.43%; arterial patency rate was 85.71%; vein patency rate was 57.14%. In group B, the total patency rate was 89.29% ; arterial patency rate was 92.56% ; vein patency rate was 85.71%. The patency rate of vein in group B was much higher than that in group A （ P 〈 0.05 ）. Conclusion There was no difference between the two groups in arterial patency whether the artery was anastomosed firstly or not. But the patency rate of vein was much higher when the vein was anasto- mosed firstly. This experiment revealed that the anastomosis of vein should be the priority in the limb or finger operation, since it can guaran- tee higher patency rate and better quality of vascular anastomosis.