腔内超声溶栓治疗犬外周血管血栓形成
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摘要
目的：探讨一种简便、有效的建立动物外周血管血栓模型的方法；评价腔内超声溶栓对动物外周血管血栓模型的疗效；观察超声溶栓对血管壁及静脉瓣膜的影响。以期指导和应用于临床外周血管血栓闭塞性疾病的综合防治。
方法：杂种犬15只，随机分为3组，每组5只。在犬双侧股动、静脉近、远端分别行4~#丝线结扎，人为造成犬后肢股动、静脉血栓。采用自身对照研究，即随机选择一侧肢体动、静脉接受超声溶栓治疗，对侧不给予特殊治疗。术后1、4、7d分别治疗5只犬，以超声溶栓仪行超声溶栓，观察记录溶栓效果及血管再通情况。股动、静脉溶栓后在两结扎线间切断、取出血管，甲醛固定后作病理切片，HE染色，做病理观察，了解血管壁
第＠零医丈管磺亡管住论支
一
及静脉瓣膜情况，并与对照组股动、静脉对照。
结果：术后第1、4、7d犬3o支股动、静脉都形成血栓：实验组股动脉
在二4126 S的时间里血管再通 14例；股静脉在 32－152 S的时间里血管再
通13例。对照组无一例血管再通。病理切片显示，实验组血管未发现明
显的血管内皮脱落及瓣膜撕裂等严重损伤，对照组无管壁内膜及瓣膜损
伤。两组比较无显著差异。
结论：本次实验结果显示股动、静脉单纯结扎法制备犬后肢血栓模型是一
种简单、有效的造模方法；腔内超声溶栓治疗外周血管血栓形成在动物模
型中安全性良好，有良好的近期效果，但远期疗效有待进一步观察研究。
Objective In order to evaluate the therapeutic effect of intraluminal ultrasound thrombolysis (UT) in treatment of peripheral vascular thrombosis, we established model of peripheral vascular thrombosis and observed the changes of vascular endothelium and venous valve after UT. Method 15 dogs were divided into three teams at random, with 5 dogs in each. The proximal and distant ends of the femoral arteries and veins in both posterior limbs of the dogs were ligated respectively to establish model of femoral arterial and venous thrombosis. The femoral arteries and veins in one limbs were selected randomly to accept UT, the other side accepted no special treatment. Dogs were treated at 1, 4, 7 day after the ligation. The formation of
the thrombi and the recanalization of the femoral arteries and veins were observed and recorded. After UT, the arteries and veins were excised and the pathologic changes in vascular endothelium and venous valve were examined. Result The thrombi were found in all the 30 arteries and 30 veins at 1, 4, 7 day after the ligation. The recanalization in femoral arteries of the UT team was 14/15 in 24-126 s. The recanalization in femoral veins of the UT team was 13/15 in 32-152 s. By comparison with the control team, there was no significant difference in vascular endothelium or venous valve injury in the UT team.
Conclusion The method of establishing model of peripheral vascular thrombosis by the ligation of the proximal and distant ends of the femoral blood vessel is simple and shows satisfied effect; UT shows satisfied short -term effect in treatment of peripheral vascular thrombosis, but more attention should be given to the long-term effect.
方法：杂种犬15只，随机分为3组，每组5只。在犬双侧股动、静脉近、远端分别行4~#丝线结扎，人为造成犬后肢股动、静脉血栓。采用自身对照研究，即随机选择一侧肢体动、静脉接受超声溶栓治疗，对侧不给予特殊治疗。术后1、4、7d分别治疗5只犬，以超声溶栓仪行超声溶栓，观察记录溶栓效果及血管再通情况。股动、静脉溶栓后在两结扎线间切断、取出血管，甲醛固定后作病理切片，HE染色，做病理观察，了解血管壁
第＠零医丈管磺亡管住论支
一
及静脉瓣膜情况，并与对照组股动、静脉对照。
结果：术后第1、4、7d犬3o支股动、静脉都形成血栓：实验组股动脉
在二4126 S的时间里血管再通 14例；股静脉在 32－152 S的时间里血管再
通13例。对照组无一例血管再通。病理切片显示，实验组血管未发现明
显的血管内皮脱落及瓣膜撕裂等严重损伤，对照组无管壁内膜及瓣膜损
伤。两组比较无显著差异。
结论：本次实验结果显示股动、静脉单纯结扎法制备犬后肢血栓模型是一
种简单、有效的造模方法；腔内超声溶栓治疗外周血管血栓形成在动物模
型中安全性良好，有良好的近期效果，但远期疗效有待进一步观察研究。
Objective In order to evaluate the therapeutic effect of intraluminal ultrasound thrombolysis (UT) in treatment of peripheral vascular thrombosis, we established model of peripheral vascular thrombosis and observed the changes of vascular endothelium and venous valve after UT. Method 15 dogs were divided into three teams at random, with 5 dogs in each. The proximal and distant ends of the femoral arteries and veins in both posterior limbs of the dogs were ligated respectively to establish model of femoral arterial and venous thrombosis. The femoral arteries and veins in one limbs were selected randomly to accept UT, the other side accepted no special treatment. Dogs were treated at 1, 4, 7 day after the ligation. The formation of
the thrombi and the recanalization of the femoral arteries and veins were observed and recorded. After UT, the arteries and veins were excised and the pathologic changes in vascular endothelium and venous valve were examined. Result The thrombi were found in all the 30 arteries and 30 veins at 1, 4, 7 day after the ligation. The recanalization in femoral arteries of the UT team was 14/15 in 24-126 s. The recanalization in femoral veins of the UT team was 13/15 in 32-152 s. By comparison with the control team, there was no significant difference in vascular endothelium or venous valve injury in the UT team.
Conclusion The method of establishing model of peripheral vascular thrombosis by the ligation of the proximal and distant ends of the femoral blood vessel is simple and shows satisfied effect; UT shows satisfied short -term effect in treatment of peripheral vascular thrombosis, but more attention should be given to the long-term effect.
引文
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3．陈铁年，陈瑞芳，杨果杰．一种家兔股动脉血管内制作血栓模型的简便方法[J]．实验动物科学与管理，1997，02：33—34
4．宋爱利，董小黎，李良，等．建立动物血栓模型方法的改进[J]．首都医科大学学报，2001，22(4)：359
5. Rhodes JM, Cho JS, Gloviczki P, 等. Thrombolysis for experimental deep venous thrombosis maintains valvular competence and vasoreactivity[J]. J Vase Surg, 2000, 31(6): 1193-1205
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