新型可降解吻合夹吻合血管的生物力学特点
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摘要
背景:目前国内外应用于临床的血管吻合器均可以克服传统血管吻合方法操作复杂、吻合时间长和内膜损伤等严重缺陷。但其不可吸收的针环影响了吻合口处血管正常收缩与舒张的生理功能,从而限制血管的生长,不适宜未成年患者。目的:分析新型可降解的吻合夹吻合血管的生物力学特点。方法:剪断新西兰大白兔双侧颈静脉,一侧应用新型可完全降解的吻合夹吻合,另一侧行针线吻合对照,测定术后当天,第7,14,30天时离体血管吻合口的平均破裂压。结果与结论:吻合夹组吻合时间短于针线吻合法(P<0.05),吻合夹组平均破裂压与针线吻合法组比较差异无显著性意义(P>0.05)。生物力学表明新型可降解的吻合夹安全可靠。
BACKGROUND: vailable anastomats appear to overcome the deficiencies of traditional anastomotic methods,such as complex operation, long time for vascular anastomosis and severe intimal injury. However, their nonabsorbable needling rings impact the normal diastolic and systolic of the blood vessels at anastomotic sites,thus limiting the growth of blood vessels, which is not suitable for minor patients.OBJECTIVE: To analyze the biomechanical characteristics of vascular anastomosis with a new-type degradable anastomosis chip.METHODS: Bilateral jugular veins of New Zealand rabbits were cut: one side was anastomosed using a new type degradable anastomosis chip, and the other side was anastomosed with sutures as control. The average maximal breaking pressure was measured at the 1st day, 7th day, 14 th day, and 30 th day after operation.RESULTS AND CONCLUSION: The anastomosis time using the anastomosis chip was lower than that using sutures(P < 0.05), and the average maximal breaking pressure exhibited no difference between the two groups(P< 0.05). It indicates that the new-type degradable anastomosis chip is safe and reliable.
BACKGROUND: vailable anastomats appear to overcome the deficiencies of traditional anastomotic methods,such as complex operation, long time for vascular anastomosis and severe intimal injury. However, their nonabsorbable needling rings impact the normal diastolic and systolic of the blood vessels at anastomotic sites,thus limiting the growth of blood vessels, which is not suitable for minor patients.OBJECTIVE: To analyze the biomechanical characteristics of vascular anastomosis with a new-type degradable anastomosis chip.METHODS: Bilateral jugular veins of New Zealand rabbits were cut: one side was anastomosed using a new type degradable anastomosis chip, and the other side was anastomosed with sutures as control. The average maximal breaking pressure was measured at the 1st day, 7th day, 14 th day, and 30 th day after operation.RESULTS AND CONCLUSION: The anastomosis time using the anastomosis chip was lower than that using sutures(P < 0.05), and the average maximal breaking pressure exhibited no difference between the two groups(P< 0.05). It indicates that the new-type degradable anastomosis chip is safe and reliable.
引文
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[21]戚悠飞,朱晒红,王国慧,等.聚L-乳酸血管吻合套管的初步研究[J].中国现代医学杂志,2012,22(16):9-14.
[22]许硕贵,朱光明,张春才.一种生物可吸收捆绑带及其形状记忆锁扣:中国,200610023175[P].2006-08-23.
[23]朱光明,许硕贵,费敬银,等.辐射交联聚己内酯的非等温结晶动力学研究[J].辐射研究与辐射工艺学报,2004,22(6):349-355.
[24]朱光明,秦瑞丰,许硕贵.具有电响应特性的形状记忆材料及其制备方法:中国,200410073393[P].2005-07-13.
[25]沈岳,钟孝正,龙在云,等.生物降解桥接套管修复显微血管的实验研究[J].中国现代医生,2008,46(24):1-2.
[26]范恒华,伍骥.血管粘接吻合密封胶(剂)的实验研究[J].医疗卫生设备,2009,30(10):1-4,7.
[27]梁向党,张伯勋,孙赓,等.微创血管粘合技术研究的初步报告[J].医疗卫生设备,2005,26(7):23-25.
[28]刘鲁伟,杨继庆,王斯刚,等.激光血管环形吻合仪的研制[J].现代电子技术,2005,28(13):89-90.
[29]查选平,宋建星,邢新,等.微型钛血管吻合夹吻合血管的生物力学研究[J].中国临床康复,2002,6(16):2388-2389.
[2]Nakayama K,Tamiya T,Yamamoto K,et al.A simple new apparatus for small vessel anastomosisi(free autograft of the sigmoid included).Surgery.1962;52:918-931.
[3]Ostrup LT,Berggren A.The UNILINK instrument system for fast and safe microvascular anastomosis.Ann Plast Surg.1986;17(6):521-525.
[4]Sullivan SK,Dellacroce F,Allen R.Management of significant venous discrepancy with microvascular venous coupler.J Reconstr Microsurg.2003;19(6):377-380.
[5]Yap LH,Constantinides J,Butler CE.Venous thrombosis in coupled versus sutured microvascular anastomoses.Ann Plast Surg.2006;57(6):666-669.
[6]Spector JA,Draper LB,Levine JP,et al.Routine use of microvascular coupling device for arterial anastomosis in breast reconstruction.Ann Plast Surg.2006;56(4):365-368.
[7]Hallock GG,Rice DC.Early experience with the new'megacoupler'ring-pins for microvascular anastomoses.J Plast Reconstr Aesthet Surg.2008;61(8):974-976.
[8]Hallock GG,Rice DC.Use of a microvascular coupler for repair of major distal upper extremity artery injuries.J Hand Microsurg.2009;1(1):3-6.
[9]刘英炳,陈受谦,杨恒文,等.73-2型血管吻合器的动物实验和临床应用[J].解放军医学杂志,1979,4(2):76-80.
[10]林民专,赵明,高伟,等.应用钛环血管吻合器建立大鼠原位肝移植模型[J].中华器官移植杂志,2000,21(6):339-340.
[11]王守界,宋建新,邢新,等.血流动力学定量指标评估微型钛血管吻合夹吻合静脉的实验研究[J].中国临床康复,2005,9(2):74-75.
[12]刘延.使用钛轮钉与手工吻合在建立动静脉内瘘上的比较[J].第四军医大学学报,2007,28(22):2043.
[13]王俊峰,谢席胜,周红梅,等.血液透析患者两种动静脉内瘘成形术的比较[J].西部医药,2008,20(5):1007-1009.
[14]刘春,王倩,周泽梅,等.建立动静脉内瘘直接缝合法与钛轮钉吻合法的对比研究[J].重庆医药,2008,37(10):1081-1082.
[15]徐政全,陶建萍.血液透析患者动静脉内瘘闭塞原因分析及预防措施[J].现代中西医结合杂志,2008,17(5):571-752.
[16]严红霞.头静脉-桡动脉内瘘闭塞的原因及预防措施[J].齐齐哈尔医学院学报,2008,29(19):2344.
[17]王云生,胡祥仁,吴孟华,等.钛轮钉血管吻合术在长期血液透析病人中的应用[J].西南国防医药,2007,17(3):316-317.
[18]罗庚,郭现辉,江宏,等.钛轮钉在动静脉内瘘中的应用[J].中原医刊,2004,33(8):25-27.
[19]周峰,叶钢.应用钛轮钉机械吻合对比手工吻合肾移植动脉的临床研究[J].重庆医科大学学报,2009,34(9):1207-1209.
[20]陈扬波,杨忠明,杨庆雄,等.应用血管吻合器治疗四肢血管伤的体会[J].中国矫形外科杂志,2001,8(3):267.
[21]戚悠飞,朱晒红,王国慧,等.聚L-乳酸血管吻合套管的初步研究[J].中国现代医学杂志,2012,22(16):9-14.
[22]许硕贵,朱光明,张春才.一种生物可吸收捆绑带及其形状记忆锁扣:中国,200610023175[P].2006-08-23.
[23]朱光明,许硕贵,费敬银,等.辐射交联聚己内酯的非等温结晶动力学研究[J].辐射研究与辐射工艺学报,2004,22(6):349-355.
[24]朱光明,秦瑞丰,许硕贵.具有电响应特性的形状记忆材料及其制备方法:中国,200410073393[P].2005-07-13.
[25]沈岳,钟孝正,龙在云,等.生物降解桥接套管修复显微血管的实验研究[J].中国现代医生,2008,46(24):1-2.
[26]范恒华,伍骥.血管粘接吻合密封胶(剂)的实验研究[J].医疗卫生设备,2009,30(10):1-4,7.
[27]梁向党,张伯勋,孙赓,等.微创血管粘合技术研究的初步报告[J].医疗卫生设备,2005,26(7):23-25.
[28]刘鲁伟,杨继庆,王斯刚,等.激光血管环形吻合仪的研制[J].现代电子技术,2005,28(13):89-90.
[29]查选平,宋建星,邢新,等.微型钛血管吻合夹吻合血管的生物力学研究[J].中国临床康复,2002,6(16):2388-2389.