大剂量体外射线照射对ePTFE人工血管吻合口的影响

目的 观察术后大剂量体外射线照射对ePTFE人工血管吻合口的影响.方法 20只杂种犬均施行肾下平面腹主动脉ePTFE人工血管置换术,术后随机分为对照组及照射组各10只.照射组术后2周予35 Gy体外射线分割照射(等效于恶性肿瘤根治性剂量70 Gy),观察照射后ePTFE人工血管吻合口大体变化以及显微镜下吻合口组织形态的改变;并应用CD34行免疫组化分析,观察射线照射对局部内皮细胞覆盖的影响.结果 与对照组比较,在术后4,8周内,照射组人工血管吻合口区域出现较明显的组织形态学改变,未见人工血管吻合口不愈合、或破裂以及局部动脉瘤形成等情况;未出现人工血管血栓形成率的增加.吻合口两侧血管CD34均为阳性.结论 短期观察内大剂量的射线对人工血管吻合口不会造成严重的影响,不会产生严重的负面效应.

The effect of high dose external beam radiation on the ePTFE prosthesis-arterial anastomosis

Objective:To explore the effect of high dose external beam radiation on the ePTFE prosthesis-arterial anastomosis.
Methods:The infrarenal abdominal aorta was replaced by ePTFE prosthesis graft in 20 dogs, and all the animals were randomly divided into 2 groups, including of irradiated groups and the control groups, which were or were not associated post-operative external radiation(35 Gy) to the anastomosis. All the animals were sacrificed at 4 weeks and 8 weeks after operation for histological and immunohistochemical examination of the prosthesis-arterial anastomosis.
Results:There was marked histological changes caused by 35 Gy external irradiation at the prosthesis-arterial anastomosis,but no disunion, rupture, or aneurysm was found at the anastomosis. Radiation did not increase the rate of thrombosis at the prosthesis. The result of immunohistochemical examination showed that two side of the anstomosis were CD34 positive. 
Conclusions:High dose of external beam(35 Gy) can cause marked histological changes at the prosthesis-arterial anastomosis, however, it will not exert negative effect on anastomosis in the short term.