【作者】 李涛；

【导师】 刘建新；

【作者基本信息】 中南大学 ， 外科学， 2012， 硕士

【摘要】 [目的]本实验测试新型免缝合人工血管植在实验动物体内血液相容性,包括血液成分改变及血栓形成的情况。以为该人工血管进一步研究改进提供必要的数据资料。[方法]在以猪为实验动物的研究中,新型免缝合人工血管(以下简称人工血管)(n=6)在全麻气管插管条件下植入受试猪体内。术后180天内持续口服华法林片进行系统抗凝治疗(抗凝强度以2.5毫克/天),比较组内实验动物在研究期间血细胞成分,红细胞损伤(血浆游离血红蛋白)和血小板激活(血浆可溶性P-选择素)等方面重复测量变量的改变。动物实验按期终止后,对取出的人工血管进行肉眼观察,苏木素-伊红染色观察及电微镜观察。[结果]所有纳入研究的6只猪均成功存活180天,研究期间内,人工血管置换后血细胞成分的变化结果：1.红细胞压积于术后30分最低,术后7天开始逐渐升高,此后出现波动,整个实验期间红细胞压积变化无统计学意义(P＞0.05)；2.血小板计数于术后30分最低,整个实验期间,血小板计数出现波动,血小板数变化无统计学意义(P＞O.05)；3.血浆游离血红蛋白含量于术后30分最高,整个实验期间血浆游离血红蛋白变化无统计学意义(P＞0.05)；4.血浆可溶性血小板P-选择素于术后30分最高,术后15天开始逐渐下降,整个实验期间血浆可溶性血小板P-选择素变化无统计学差异(P＞0.05)。终止实验后,新型免缝合人工血管血栓形成观察：1.大体标本肉眼观察：肉眼未见明显有型血栓形成；2.苏木素-伊红染色观察：人工血管内表面有血管内皮细胞及平滑肌细胞,未见血栓形成；3.电镜观察：人工血管内壁有少量内皮细胞附着,局部见内皮细胞凋亡碎片,未见血栓形成。[结论]该型免缝合人工血管具有良好的血液相容性,不引起有意义的血液成分变化,不引起血栓形成及自体血管组织坏死。更多还原

【Abstract】 [Objective] This experiment in animals will test the hemocompatibility, such as the changes of blood components and thrombosis of them in order to accumulate necessary data for its clinical practice.[Methods] With pigs for experimental animals in the experiment, the new sutureless prostheses for vascular (will be called for short as prostheses for vascular)(n=6) were implanted in pig body by operations in anesthesia condition, the procedure of operations contain making incision in in left lateral, establishment of the bypass circulation, excision of a length the thoracic aorta, placement of the prostheses for vascular. Afterwards, the pigs got continuous anticoagulant therapy by feeing warfarin (2.5mg/day) for four months. We compared the changes in blood cells composition, red blood cell damage (plasma free hemoglobin) and platelet activation (P-selectin in plasma). After the termination of the experiment, we took out of that prostheses for vascular then observation by naked eye, Haematoxylin-Eosin (H&E) staining and electron microscope.[Results] All pigs (6) included in the experiment successfully live for180months. After replacement prosthesis for vascular the change in the composition of the blood cells:1. The HCT (hematocrit) was the lowest on30min after the operators that we implanted the prostheses in the pigs and increased gradually then fluctuated. During the whole experiment, the HCT change was not significantly statistical difference (P>0.05);2. The minimum platelet count was on30min after the surgeries. In the whole experiment, the platelet count change have no significantly statistical difference (P>0.05);3. The plasma free hemoglobin appeared a maximum value30min after the animal operations. During the whole trial, the change of plasma free hemoglobin was not significantly statistical difference (P>0.05);4. The peak value of p-select in Plasma appeared30min after operations then gradually began to decline after15days. During the whole experiment, its value was not significantly statistical difference (P>0.05) On the termination of the experiment, the thrombosis observation:1. the observation by naked eye:there were no obvious thrombus;2. the observation by Haematoxylin Eosin (H&E) staining:the surface of prostheses for vascular and the connection surfaces of the prostheses and the vascular were covered with endothelial cells, no thrombus in their surface;3. the observation by electronic microscope:there was a small amount of endothelial cells covered on the internal surfaces, locally endothelial cell apoptosis debris, no thrombus attached the internal layers.[Conclusions] The new sutureless prostheses for vascular have good hemocompatibility and don’t cause significant changes of blood components, thrombosis and autologous vascular tissue necrosis.更多还原