微创血管粘合技术研究的初步报告

目的:研制一种简便、快捷、高质量的血管吻合方法。方法:我们自行研制了一种中空可溶性血管内支架,选用医用粘合剂对新西兰兔股动脉进行血管粘合实验,对侧股动脉作为对照组行血管缝合实验,并对2组的吻合时间、通畅率、吻合口的渗漏以及吻合口愈合情况进行了比较;通过血管造影、吻合口组织病理切片等手段对远期吻合口愈合情况进行了初步评价。结果:粘合组血管平均吻合时间为7.91min,缝合组12.9min,统计学分析有显著性差异;即刻通畅率2组均为100%;远期通畅率粘合组为80%,缝合组为90%,2组统计学分析没有显著性差异;近期观察吻合口无渗漏,远期观察吻合口无明显狭窄,血管内膜愈合好没有明显增生。结论:该吻合法屏弃了缝针缝线,减少了吻合过程中的创伤;应用支架较好地解决了吻合口狭窄以及黏合剂进入管腔等问题;黏合剂的使用又避免了吻合口的渗漏,血管吻合质量明显提高;黏合剂聚合凝固时间短以及支架的中空结构使得血管吻合速度明显提高;该方法操作简便容易掌握,因此是一种简便、快捷、高质量的血管吻合方法。

Primary experimental study on a new sutureless vascular bonding method

Objective This paper is to study a new sutureless vascular bonding method. Methods New-Zealand rabbits were randomly assigned to one experimental group and one control group. 10 end-to-end bonding on rabbit femoral arteries (1.2mm vessel) were performed using the experimental technique with histoacryl glue (OB) and a central channel soluble stent. In the control group, 10 rabbit femoral arteries (1.2mm vessel) were anastomosed with the standard suture method. The patency rates and anastomotic time were recorded. The late anastomoses were evaluated with arteriograph and stoma tissue pathological section. Results The anastomosis mean time of the experimental group is 7.91 minutes and the one of the control group is 12.90 minutes. The immediate patency rates of two groups are both 100% and the late patency rates are 80% and 90% respectively. There are no haemorrhage when the clamp released and no distortion and stricture caused by sutures. Conclusion The sutureless vascular bonding method has no needs for suture needle and line, and thus the possible injuries during suture are reduced. The stent makes the vessel free from stoma stricture and binder invasion. The stoma leakage is also avoided through the adhensive. The enhanced suture speed results from the short clotting time and the hollow structure of the stent. With all the above-mentioned excellences, the method proves simple and efficient.