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目的采用家兔的股动静脉为模型进行血管吻合,探讨在断肢或断指时优先吻合动脉还是静脉通畅率更高,为临床外科医生在动静脉吻合优先选择上提供参考。方法将生理状况相同的健康幼龄家兔56只分为优先吻合股动脉(A组)与优先吻合股静脉(B组)2组,每组各28只。每只家兔切断股动脉和股静脉,血管断端暴露20 min后再行血管端端吻合术;记录所用时间和针数;72 h后观察血管通畅情况。结果 A组中动静脉均通畅者16例;动脉通畅静脉不通畅8例;动静脉均不通畅者2例;术中致死2例;手术总用时间平均(51.21 8.46)min。B组中动静脉均通畅者22例;动脉通畅静脉不通畅者4例;动静脉都不通畅者2例;手术总用时平均(42.42 2.90)min。A组总通畅率是71.43%;动脉总通畅率是85.71%,静脉总通畅率是57.14%。B组总通畅率89.29%;动脉总通畅率是92.56%;静脉总通畅率是85.71%。B组静脉通畅率明显高于A组(P<0.05)。结论无论动脉先吻合还是后吻合对动脉通畅率无影响,但是优先吻合静脉血管比后吻合静脉血管的静脉通畅率要高。本实验提示在断肢或断指手术时应优先吻合静脉,可以保证通畅率和血管吻合的质量。
Objective To study the anastomosis of rabbit femoral artery and vein for the model of vascular anastomosis to discuss whether the anastomosis of the artery or venous patency is preferred when the limbs or severed fingers are severed or not and provide the reference for clinical surgeons in the choice of arteriovenous anastomosis. Methods Fifty-six healthy young rabbits with the same physiological status were divided into 2 groups (A group) and preferential dorsal femoral vein (B group), 28 in each group. Each rabbit was cut off femoral artery and femoral vein, vascular end-to-end exposure 20 min before vascular end-to-end anastomosis; record the time and number of needles; 72 h after the observation of vascular patency. Results In group A, 16 patients had arteriovenous patency; 8 patients had unobstructed arterial patency; 2 patients had unmovable arteriovenous patency; 2 patients died during operation; and the total operation time averaged (51.21 8.46) min. In group B, 22 patients had arterio-venous patency; 4 patients had unobstructed arterial patency; 2 patients had both arterio-venous patency; and the average operation time was 42.42, 2.90 min. The total patency rate was 71.43% in group A, 85.71% in total arterial patency and 57.14% in total patency. The total patency rate was 89.29% in group B, 92.56% in total arterial patency, and 85.71% in patency. The rate of venous patency in group B was significantly higher than that in group A (P <0.05). Conclusion No matter whether the anastomosis of the artery or the anastomosis has no effect on the patency of the artery, the rate of patency of the anastomosed vein is higher than that of the anastomosis of the vein. This experiment suggests that in severed limb or severed finger surgery should be given priority to vein, patency rate can ensure patency and vascular quality.