摘要
目的探讨生物膜等4类材料包裹治疗犬梭形动脉瘤(FFA)模型的远期疗效。方法 10只犬的20枚梭形动脉瘤分别用生物膜、自体颈外静脉(EJV)、膨体聚四氟乙烯膜片(e-PTFE)、涤纶片等建立完全匹配包裹模型各5枚,观察建模后血流动力学变化与病理学改变。结果随建模时间延长,EJV降解、模型膨胀性增大,瘤壁机化、钙化、炎症反应严重,24个月破裂并闭塞1枚;涤纶片无降解、瘤壁炎症反应严重,6个月5枚瘤腔完全闭塞;e-PTFE无降解、瘤壁炎症反应轻、有钙化趋向,24个月e-PTFE出现1枚闭塞;生物膜包裹3个月后开始多层次降解,并诱导组织再生,无炎症反应。高频超声动态观察提示不同包裹材料与瘤壁微小间隙、增生斑块、血管弹性等的演变过程以及模型的不同部位血流速度有着不同的变化(P<0.05)。结论包裹材料的生物力学稳定性与组织排斥反应是影响血流动力学与包裹远期疗效的关键因素。生物膜被动降解同时原位诱导组织再生,具有良好的力学稳定性与生物相容性,是动脉瘤包裹治疗的理想材料。
Objective To examine the hemodynamics changes and the pathological features on the canine fusiform aneurysm （FFA） models after being wrapped by biological graf and so on, and to evaluate the long-term effect of four kinds graft in wrapping of cerebral aneurysms. Methods Twenty FFA canine models were reproduced in 10 experimental dogs were randomly divided into A （biological graf）, B （autogenous external jugular vein, EJV）, C （expanded polytetrafluoroethylene, e-PTFE）, D （Dacron film） four groups, five for each group, using perfect match state method were wrapped for the treatment. High fre- quency ultrasound was carried out in 1, 3, 6, 12 and 24 months and pathological features were evaluated in 24 months after surgical procedure. Results Along with the prolongation of time. EJV completely degraded and absorbed, the models grew in an expansile way and the aneurysms wall ill-defined, inflammatory cell infiltration, calcification, and organization. But there was one case spontaneous ruptured and occluded at 24 months following surgery. The aneurysmal cavities were occluded after Dacron wrapping in five cases at six months after operation, the materials without degradation and a large number of lymphocytes and diffuse macrophage infiltration in the inner wall. After wrapped in e-PTEE no degradation of material, scattered infiltration of lymphocytes and a small amount of macrophages, with time, the hardness tends to increase with calcification, But there was one case occluded after e-PTFE wrapping at 24 month after operation. The biological graft was fused with wall of an- eurysm at three months after operation and with the extension of time, the aneurysm wall with multis trata degradation, and many tiny interspaces emerged in the internal which induced the ingrowths of new vessels and tissues; no inflammatory cells were found. High frequency ultrasound dynamic observe may clearly reveal the changes in the wrappings for the tiny gap between tumor wall and materials, plaques, Elastic vessels, as well as the blood velocity varied in different parts of the aneurysm Wrapped with different materials （P〈0.05）. Conclusion The stability of biomechanical performance and transplant rejection of wrapping material is one key to control hemodynamics and the long-term effect in wrapping of cerebral aneurysms. The biological graft can passive degradation and in situ induce tissue regeneration simultaneously maintain a good stability and bioeompatibility that will be bound to be the best treatment for aneurysm.
出处
《福建医药杂志》
CAS
2011年第5期1-5,F0003,共6页
Fujian Medical Journal
基金
福建省科技计划青年人才项目(2008F3027)
关键词
动脉瘤模型
包裹材料
高频超声
生物力学性能
炎症反应
aneurysmal model
wrapping material
high-frequency ultrasound
biomechanical performance
inflammatory response
