顺行和逆行取栓对静脉瓣膜及血管壁的影响

目的：比较顺行取栓与逆行取栓在猪腋静脉急性血栓形成对于其瓣膜功能和静脉壁形态的影响。方法：分别结扎猪的腋静脉的近远端，于结扎段内注入凝血酶原，放置６ｈ使形成血栓。随机分配为顺行取栓和逆行取栓组，对血栓段进行取栓。取栓后２４ｈ行取栓静脉插管逆行造影以评估瓣膜功能；切取此段静脉作ＣＤ８＾＋细胞免疫组化和苏木精－伊红（ＨＥ）染色以对比血管内膜及平滑肌的损伤程度。结果：逆行与顺行取栓在所有的例数中都成功地

The effect of ascending and descending thrombectomy on valvular competence and venous wall morphology in experiment

Objective:To compare the effect of ascending and descending balloon catheter thrombectomy on valvular competence,vein wall morphology after deep vein thrombosis in pigs.Methods:The axillary veins were blocked proxima and distal by bul dog clamp and thrombinogen was injected into the lumen for 6 hours to induce deep venous thrombosis,then the veins were assigned to ascending and descending thrombectomy group randomly. Tweenty four hours after thrombectomy valvular competence was determined with descending venography.Structural integrity of the endothelial layer and smooth muscle were determined with light microscopy.Results:Thrombectomy was performed successfully in all cases.In ascending group there were 2 mild reflux and 6 non reflux as compared with 6 severe relux and 2 mild relux in descending group( P <0.05) and there were corresponding results on valvular morphology.There was no significant disparity on veins wall morphology between the two groups( P >0.05).Conclusions:Ascending and descending thrombectomy injured the vein wall in similar degree,but for valvular competence preserving ascending thrombectomy is more effective than descending thrombectomy.