摘要
目的探讨人体四肢正常动、静脉的纵向残余应变特性和应力－应变关系，以及人体四肢主要动脉伤不同长度血管损伤与修复方法选择之间的关系，比较由于血管纵向生物力学特性而产生的修复差异，为临床血管损伤的修复效果及近、远期疗效评价提供依据。方法以人体正常血管标本为研究对象，通过血管拉伸试验及检测血管纵向伸长率，获取四肢正常动、静脉纵向残余应变及应力－应变变化规律。对损伤部位相同而修复方法不同的血管真性缺损长度做 t检验，通过 95％分布区间分析两种修复方法的选取界限。对自体静脉移植修复血管中真性缺损长度与移植长度作线性相关与线性回归分析。结果人体四肢主要动脉由近心端向远心端纵向伸长率逐渐减小，应力－应变关系曲线逐渐右移，静脉与之相反；相对应部位动、静脉间应力－应变关系曲线差异有非常显著性意义 (P< 0.01)。四肢主要动脉与头静脉、大隐静脉纵向伸长率间差异有显著性意义 (P< 0.05)。根据血管真性缺损长度选择端端吻合与自体静脉移植修复肱动脉、股动脉、动脉伤，缺损长度间差异有非常显著性意义 (P< 0.01)。静脉移植修复肱动脉、股动脉、动脉真性缺损长度与移植长度间存在线性相关。结论人体四肢主要动脉由近心端向远心端，纵向残余应变逐渐减小。
Objective To investigate the longitudinal residue strain and stress-strain relation of normal human vascular system of the extremities and the relation between the different defect length and the option of repair, as well as a comparison of the different selection of the methods of repair judged from the longitudinal biomechanical effect. Methods A mechanical analysis including stretch experiment and longitudinal stretch ratio measurement were undertaken to evaluated the longitudinal residue strain and stress-strain relation of arteries and veins of the extremities in human. The results of different methods for repair of the defect of the same kind of vessels were compared with Student-t test. The length precinct to repair arterial injuries between end-to-end anastomoses and vein graft through 95％ distribution region was evaluated. Results The longitudinal stretch ratio of arterial system of the extremities decreased from the proximal to the distal ends of the vascular branches and the stress-strain relation curve of artery turned gradually to the right side, while that of veinous system exhibited a contrary picture. There was significant difference among the stretch ratio of artery and those of branchiocephalic vein or great saphenous vein (P< 0.05). A significant difference was also seen between the defect length of brachial artery repaired by end-to-end anastomosis and the defect length of brachial artery repaired by autogenous vein graft (P< 0.01). The same thing happened with the injured femoral artery and popliteal artery (P< 0.01). Conclusion The longitudinal residue strain and the stiffness of extremities artery decreased along the vascular branches however there was an increase of the same parameters in the venous system. These results suggested that in the repair of the different vascular injuries the selection of surgical method must be in concert with the different biomechanical effect.
出处
《中华骨科杂志》
CAS
CSCD
北大核心
2000年第10期617-620,共4页
Chinese Journal of Orthopaedics
基金
国家自然科学基金资助项目!( 19502009)
关键词
生物力学
吻合术
四肢动脉损伤
应力-应变
Biomechamics
Extremities
Arteries
Wounds and injuries
Anastomasis,surgical
