血管吻合技术与微栓子形成关系的实验研究

目的　研究血管吻合技术与微栓子形成的关系及其对微循环的影响。方法16只雄性Sprague-Daw-ley大鼠制备右侧提睾肌模型后,随机分为两组,血管吻合技术良好组与吻合技术差组,采用活体微循环观察和计算机图像处理技术,观测通过提睾肌第一级微动脉的微栓子数量、面积和毛细血管灌注的变化,扫描电镜观察微栓子的组成及变化。结果 吻合技术良好组微栓子的平均数量和面积均明显比吻合技术差组少（P<0.01）;吻合灌注后3h功能毛细血管密度降到基础值的57.6％;微栓子内的血小板出现显著脱颗粒。结论 血管吻合后产生微栓子的数量与吻合技术的优劣密切相关;微栓子释放的血管活性物质降低微循环的灌注;吻合技术通过微栓子改变功能毛细血管的密度而影响组织存活。

Experimental Study on the Relationship Between Anastomotic Technique and Microemboli

Objective To investigate the relationship between anastomotic technique and microem-boli and study on the effect of microemboli on microcirculation. Methods Sixteen isolated cremaster models prepared from male Sprague - Dawley rats were seperated randomly into two groups. Anastomosis was performed on the iliac artery with the standard arterial repair technique (group I , good technique) and with inverting the arterial wall into the vessel lumen technique (group II , poor technique). The number and area of emboli passing through the principal arteriole feeding the cremaster muscle and the percentage of change in the number of perfused capillaries were searched and measured with the aid of a vital microscope equipped with closed - circuit video television recording system and image analysis system. Microemboli were observed through the transmission electron microscope. Results The average number and areas of microemboli in group I were significantly less than those of group II . Functional capillary density gradually decreased to 57.6% of the basal value after 3h reperfusion. Platelet emboli markedly secreted vasoactive substances. Conclusion Microemboli appeared following vessel repair. The number of microemboli were related to the anastomotic technique. Vasoactive substances released from microemboli significantly decreased microcirculation perfusion. The anastomotic technique affects functional capillary density through microembolization and moreover influences the tissue survival.