背景:良好的可视化是进行微血管吻合的先决条件。最常用的染料-亚甲基蓝具有若干限制:其被快速洗掉并且染色所有容器层。我们研究的目的是使用两种新型染料来改善可视化。
方法:在伦理委员会批准后,两种染料(2%甲酚紫,1%伊红)分3组进行研究,每组20只,联合组5只。在45只大鼠中以经典方式进行端侧吻合。静脉切开术后,然后将染料应用于血管的原始表面,然后进行吻合。可视化的改善由四组中的3名失明专家和非专家以1至10的量表来判断,得分进行统计学分析。两周后,动物被重新探索以检查延迟的通畅性,并收获节段进行组织病理学分析。
结果:立即和延迟开放率分别为-100%(45/45)和97%(33/34)。在统计分析中,由于颜色对比,联合组(p=0.005)被认为具有统计学意义.所有的层都被染料染色,染色持续到手术结束。在甲酚紫中,切割端的能见度要好得多。所有组织病理学发现均提示吻合部位发生正常变化。
结论:这项研究表明,使用这两种染料不仅是可行的,而且是非常有效的。即使所有的层都被两种染料染色,切口的能见度要好得多。在两种染料中,染色一直持续到手术结束。据我们所知,这是首次在实验环境中使用这两种新型染料改善微血管吻合可视化的研究.
Good visualization is a prerequisite for performing microvascular anastomosis. The most commonly used dye, methylene blue, has several limitations: it is washed off quickly and stains all the vessel layers. The objective of our study is to use 2 new novel dyes for improving visualization.
After ethical committee approval, 2 Dyes (2% cresyl violet, 1% eosin) were studied in 3 groups, 20 rats in each group and 5 rats in the combined group. End-to-side anastomosis was performed in the classic fashion in 45 rats. After venotomy, the dye was applied to the raw surface of the vessels and subsequently, anastomosis was performed. The improvement in visualization was judged by 3 blinded experts and nonexperts in 4 groups on a scale of 1-10. Scores were statistically analyzed. After 2 weeks, animals were re-explored to check the delayed patency, and segments were harvested for histopathologic analysis.
The immediate and delayed patency rates were 100% (45/45) and 97% (33/34), respectively. In statistical analysis, the combined group (P = 0.005)was judged statistically significant because of the contrast in color. All the layers were stained by both dyes, staining lasted until the end of the surgery. Visibility of the cut ends was better in cresyl violet. All histopathologic findings suggested normal changes at the anastomotic site.
This study showed that the use of these 2 dyes was not only feasible but highly efficacious. Even though all the layers were stained by both the dyes, the visibility of the cut ends was better. In both dyes, staining lasted until the end of surgery. To the best of our knowledge, this is the first study that has used these 2 novel dyes to improve visualization in microvascular anastomosis in an experimental setting.