再植肢体不同时间主要静脉闭塞对其成活的影响

目的研究大鼠再植肢体不同时间主要静脉闭塞对其成活的影响. 方法选择成年SD大鼠25只,按大腿离断再植术后股静脉切断的时间随机分成5组,即2、3、4、6和8 d组,每组5只.股静脉切断后对再植肢体进行肉眼观察、皮温测量和血管造影检查. 结果 2 d组静脉回流严重受阻,未见新生侧支血管形成,再植肢体坏死.3 d组再植肢体的股静脉少量充盈,近侧有逐渐增多的侧支血管,但通过再植平面者稀少,再植肢体均发生大部分坏死.4 d组股静脉切断后早期常存在暂时性再植肢体供血不足现象,但再植肢体能成活.6 d和8 d组,随着时间的延长,再植肢体静脉回流逐渐改善.2 d和3 d组测量缺血肢体术前和术后温差在4.5℃以上、肌肉的毛细血管密度少于30/mm2、毛细血管肌纤维率少于0.2、血管造影评分少于0.1的再植肢体常最终坏死. 结论大鼠断肢再植术后3 d内如主要静脉阻断,再植肢体将发生坏死;4 d后再植肢体可以依靠新生侧支血管的静脉回流得以成活.

EFFECT OF FEMORAL VEIN-OCCLUSION ON REPLANTED LIMB SURVIVAL AT DIFFERENT STAGES

Objective To study the effect of vein-occlusion on the replanted limb survival in SD rats at different stages. Methods Twenty-five adult SD rats were randomly divided into 5 groups according to the time of the femoral vein occlusion after the replanted limbs:2-,3-,4-,6-,and 8- day groups. The limbs were observed through naked eye, measurement of dermal temperature and angiography. Results No formation of collateral veinlet was found, and necrosis was seen in the replanted limbs of 2-, 3- day groups. Reflux-vein was gradually increased in the replanted limbs of 4,6,and 8 day groups. Angiographic score of capillary density and dermal temperature in the thigh muscles were greater in groups 4-,6-,and 8- day than in groups 2- and 3- day. Conclusion Within 2 and 3 days,the replanted limbs of SD rats will necrose because of vein-occlusion; and 4 days later the replanted limbs can survive depending on the reflux-vein of new collateral veinlet.