摘要
目的比较3种不同头端形状电凝导管的电凝效果。方法将12只狼犬(24条后肢静脉)随机分为3组,每组4只:柱状金属头组、环状金属丝组和放射状金属丝组,高位结扎电凝大隐静脉,分别在术后即刻、7d、14d取血检查活化部分凝血活酶时间(activated partial thromboplastin time,APTT)并取材大隐静脉进行HE染色,比较3组电凝后大隐静脉破坏深度、破坏范围和管腔残留、皮肤烧伤情况。结果术中柱状金属头组出现1条左后肢皮肤烧伤。术后即刻放射状金属丝组电凝破坏范围>50%管腔周长有8条后肢,明显大于柱状金属头组的3条后肢和环状金属丝的4条后肢(Fisher's Exact test,P=0.013,P=0.038);放射状金属丝组电凝破坏深度达到中膜有1条后肢,明显小于柱状金属头组的7条后肢和环状金属丝组的6条后肢(Fisher's Exact test,P=0.005,P=0.020)。术后7d3组电凝导管管腔残留>50%管腔周长的后肢比较无明显差异(χ2=5.371,P=0.068)。术后14d柱状金属头组和环状金属丝组管腔残留>50%管腔周长的7条和6条后肢,明显多于放射状金属丝组的1条后肢(Fisher's Exact test,P=0.020,P=0.005)。术后即刻、7d、14d3组APTT值均无明显差异(P=0.905,P=0.871,P=0.865)。结论放射状金属丝电凝导管比柱状金属头和环状金属丝电凝导管对管壁破坏范围更广、管腔残留周长更小,电凝效果更好,并发皮肤烧伤几率更低。
Objective To compare electrocoagulation effects of three types of electrodes for varicose veins. Methods Twelve dogs （24 veins in hind limbs） were randomly divided into 3 groups with 4 dogs in each group： columnar electrode group, circular electrode group, and radial electrode group. Each dog＇ s long saphenous veins were high ligated and electrocoagulated. The activated partial thromboplastin time （APTT） was measured and pathological examinations （HE and Weigert） were performed immediately following operation and on the 7th and the 14th postoperative day, respectively. The destruction depth and extent, residual vessels, and skin burn after electrocoagulation were compared among the three groups. Results One case of skin burn on the left hind limb occurred in the columnar electrode group. Immediately following the operation, the number of vessels that were destroyed beyond 50% of perimeter in the radial electrode group was 8, which was significandy higher than that in the columnar electrode group （3 vessels） and the circular electrode group （4 vessels） （Fisher＇ s exact test,P = 0. 013 and 0. 038）, and the number of vessels that were destroyed deep to the meddle membrane in the radial electrode group was 1, which was significantly lower than that in the columnar electrode group （7 vessels） and the circular electrode group （6 vessels） （Fisher＇ s exact test, P =0. 005 and 0. 020）. On the 7th day after operation, there was no statistical difference among the 3 groups in the number of vessels with remnant area above 50% of the perimeter （X^2 = 5.371, P = 0. 068）. On the 14th day after operation, the number of vessels with remnant area above 50% of the perimeter in the radial electrode group （1 vessel） was significantly lower than that in the columnar electrode group （7 vessels） and the circular electrode group （6 vessels） （Fisher＇ s exact test, P = 0. 005 and 0. 020）. There was no statistical difference among 3 groups in APTT immediately following operation and on the 7th and the 14th postoperative day （ P = 0. 905, 0. 871, and 0. 865 ）. Conclusions Compared with the other two catheters, radial electrode has the largest destroyed area, the smallest remnant area of the vessel, and the lowest risk of skin burn.
出处
《中国微创外科杂志》
CSCD
2007年第4期380-382,共3页
Chinese Journal of Minimally Invasive Surgery
关键词
电凝术
静脉曲张
下肢
Electrocoagulation
Varicose vein
Lower extremity
