摘要
目的利用磁吻合技术(magnetic compressive anastomosis,MCA)原理,建立一种应用于腹腔大血管部分切除后可快速完成人工血管置换的磁性装置并观察效果。方法选择健康成年杂交犬16只,雌雄不限,按下腔静脉(inferior vena cava,IVC)部分切除后进行人工血管置换吻合方式不同,随机分为MCA组与手工缝合(manual suture,MS)组,每组8只。比较MCA与MS技术吻合效果,观察两组吻合时间、术中吻合口渗漏血情况、术后彩色多普勒超声与血管造影检查血流及并发症情况。结果MCA组血管吻合耗时(6.25±2.25)min,短于MS组的(27.32±5.12)min(P<0.001);MCA组术中吻合口无渗漏血发生,MS组有4例出现渗漏(P=0.077),差异无统计学意义;血管X线造影与彩色多普勒超声检查显示MCA组吻合口血流通畅,无狭窄及血栓形成;MS组术后4~12周时共发现3例吻合口轻度狭窄并发症(P=0.200),差异无统计学意义。MCA组较MS组血管壁各层有较好衔接,吻合口炎性反应轻微。结论磁性人工血管置换装置提供了腹腔大血管切除后可应用的一种简单、快速、吻合效果可靠的快速人工血管置换方法,能够减少因传统缝合技术与材料导致的吻合口并发症。
Objective To evaluate the performance of the magnetic artificial blood vessel device for fast non-suture anastomosis of caval reconstruction with artificial blood vessel transplantation after resection in canines.Methods Sixteen adult mongrel dogs of either gender were randomly divided into two groups for vena cava reconstruction with artificial blood vessel transplantation after inferior vena cava(IVC)resection.Group MCA(n=8):magnetic artificial blood vessel device for IVC reconstruction;Group manual sewing(MS)(n=8):hand suturing for IVC reconstruction.Operation time and stoma errhysis were recorded during operation.Patency and stoma stenosis were confirmed via color Doppler ultrasound scanning and X-ray cholangiography at different timepoints as late as 4 weeks after surgery.Results The time required to perform the vascular anastomosis was significantly shorter for the magnetic artificial blood vessel device(6.25±2.25)min than for MS(27.32±5.12)min(P<0.001).There were four cases of stoma errhysis in MS group which had to be repaired(P=0.077).Vascular X-ray angiography and color Doppler ultrasound found normal blood flow and no stoma stenosis in MCA group,but three cases of stoma stenosis in MS groups(P=0.200).Compared with MS group,the magnetic ring device stoma was associated with smooth re-endothelialization and depressed infiltration of inflammatory cells at the anastomotic site.Conclusion The magnetic artificial blood vessel device offers a simple,fast,reliable,and efficacious technique for vena cava reconstruction with artificial blood vessel transplantation.
作者
刘仕琪
慈红波
雷鹏
吕毅
宋宇龙
王善佩
白纪刚
LIU Shiqi;CI Hongbo;LEI Peng;LÜ Yi;SONG Yulong;WANG Shanpei;BAI Jigang(Medical College of Xijing University, Xi’an 710123;Department of Vascular Surgery, People’s Hospital of Xinjiang Uygur Autonomous Region,Urumqi 830001;Department of Hepatobiliary Surgery, General Hospital of Ningxia Medical University, Yinchuan 750004;Department of Hepatobiliary Surgery, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an 710061;Department of Anesthesiology, Shaanxi Provincial People’s Hospital, Xi’an 710068, China)
出处
《西安交通大学学报（医学版）》
CAS
CSCD
北大核心
2021年第1期70-74,共5页
Journal of Xi’an Jiaotong University（Medical Sciences）
基金
国家自然科学基金资助项目(No.81470896)
陕西省重点产业创新链(群)-社会发展领域项目(No.2020ZDLSF02-03)。
关键词
下腔静脉
人工血管
血管置换
犬
磁吻合技术
inferior vena cava
artificial blood vessel
vessel transplantation
Mongrel dog
magnetic compression anastomosis
