泡沫硬化剂联合电凝闭合兔静脉病理学研究

发布时间：2019-06-18 15:26

【摘要】：目的：本研究通过动物实验，动态观察运用聚桂醇泡沫硬化剂联合电凝闭合兔静脉病理学变化过程，运用VEGF免疫组织化学染色，观察实验兔的静脉血管内皮细胞的破坏、再生及血管是否再通等情况。观察、比较运用聚桂醇泡沫硬化剂联合电凝对静脉闭合效果以及静脉血管再通的影响。为聚桂醇泡沫硬化剂及其联合电凝用于治疗下肢静脉曲张提供实验病理学依据。方法：健康成年普通家兔75只，随机分为3组，再将各组按取标本时间再分别随机等分5小组，每组5只家兔，做好编号。以不同方法处理实验家兔双侧股静脉，A组行聚桂醇泡沫硬化剂注射，应用1%浓度聚桂醇注射液与空气按1：4配制泡沫硬化剂；B组行电凝术，电凝能量选择30～40W；C组联合运用两种方法，电凝后注射硬化剂。实验处理后将各再等分小组家兔分别1d、3d、7d、14d、3m以过量麻醉处死，取家兔股静脉及其周围组织作为标本，10％甲醛溶液固定，常规石蜡包埋，行HE染色和VEGF免疫组织化学染色。光镜下观察：无菌性炎症改变情况，血管壁内皮损伤程度及周围组织破坏、血栓形成情况，纤维化的程度，血管再通等；观察VEGF阳性结果为血管内皮细胞及血管周围细胞胞浆染成淡黄至棕黄色，每张切片随机观察l0个高倍视野(×400)，统计各组各时段VEGF阳性细胞百分比(PP)及阳性细胞染色强度（SI），计算免疫反应积分（IRS=PP*SI）,各组各时段评分采用多样本方差分析，q检验。用SPSS19.0软件进行统计处理。结果：术后1d，三组均出现血管内皮细胞破坏，血管壁细胞水肿，血小板聚集，血栓形成；电凝组及联合组血管周围组织破坏严重，纤维细胞凝固样坏死，平滑肌细胞结构不清，无菌性炎症较聚桂醇泡沫硬化剂组严重；VEGF阳性细胞免疫反应积分（IRS）示三组无明显差异（P0.05）。术后3d，聚桂醇泡沫硬化剂组血管内皮细胞破坏、管壁细胞水肿、无菌性炎症反应等达到高峰，电凝组及联合组较术后1d无明显变化；三组VEGF阳性细胞IRS均低，且P0.05，差别无统计学意义。术后7d，三组均有部分血栓机化与管壁黏连，血管壁破坏加重，炎症细胞浸润；三组VEGF阳性细胞IRS增高，且P0.05，差别无统计学意义。术后14d，，，三组均有血栓机化，血管壁严重破坏、轮廓形态不清或消失，炎症反应减轻；三组VEGF阳性细胞IRS继续增高，且P0.05，差别无统计学意义。术后3m，三组均出现闭塞静脉血管再通，周围坏死组织吸收，炎症消失。结论：1、聚桂醇泡沫硬化剂、电凝或两者联合均可有效闭塞家兔静脉。 2、聚桂醇泡沫硬化剂、电凝或两者联合使用闭塞家兔静脉都存在血管内皮细胞再生现象，远期闭塞静脉再通。 3、聚桂醇泡沫硬化剂联合电凝较单独运用两种方法闭塞静脉后不增加也不减少内皮细胞增生及血管再通的程度。
[Abstract]:Objective: To observe the changes of venous pathology in the rabbit by using the combination of polycinnamyl alcohol and foam sclerosing agent, and to observe the damage, regeneration and the vascular recanalization of the vascular endothelial cells in the experimental rabbits by using the immunohistochemical staining of VEGF. The effect of combined electrocoagulation on the effect of combined electrocoagulation on the effect of vein closure and the recanalization of venous blood vessels was compared. The invention provides experimental and pathological basis for the treatment of varicose veins of the lower limbs by using the polycinnamyl alcohol foam hardener and the combined electrocoagulation thereof. Methods:75 healthy adult rabbits were randomly divided into 3 groups. The two-sided femoral vein of the experimental rabbits was treated with different methods. The group A was injected with the foam hardener of the group A. The foam hardening agent was prepared by 1:4 with the concentration of 1%. The electrocoagulation of group B and the selection of electrocoagulation energy were 30-40W, and the combination of group C and group C was used in combination. Method of injection hardening after electrocoagulation The rabbit femoral vein and its surrounding tissues were used as the specimen, the 10% formaldehyde solution was fixed, the normal paraffin was embedded, the HE staining and the immunohistochemical staining of VEGF were performed. Color. Under light microscope, the condition of aseptic inflammation, the degree of vascular wall injury, the destruction of surrounding tissues, the formation of thrombus, the degree of fibrosis, and the recanalization of the blood vessel were observed. The positive results of VEGF were observed as vascular endothelial cells and the cytoplasm of the peripheral cells of the blood vessel were stained with pale yellow to brown yellow. The percentage of VEGF-positive cells (PP) and positive-cell staining intensity (SI) in each group of each group were counted randomly, and the percentage of VEGF-positive cells (PP) and positive-cell staining intensity (SI) in each group were counted, and the immune response integral (IRS = PP * SI) was calculated. Inspection. Statistical Office with SPSS19.0 software Results: In the first day of the operation, vascular endothelial cell destruction, vascular wall cell edema, platelet aggregation and thrombosis were observed in three groups. The results showed that there was no significant difference between the three groups (P0.05). 05).3 d after the operation, the vascular endothelial cells of the polycyl foam hardener group were damaged, the wall cell edema and the aseptic inflammation reaction reached the peak, and there was no significant change in the electrocoagulation group and the joint group after the operation. The expression of VEGF positive cells in the three groups was higher than that of the other three groups, and there was no statistical difference between the three groups. The expression of VEGF-positive cells in three groups was not clear or disappeared, and the inflammatory response was relieved. The IRS of three groups of VEGF-positive cells continued to increase, and the difference of the three groups was not statistically significant. The results showed that 3 m after operation, the three groups of the three groups showed a recanalization of the vein, the surrounding necrotic tissue was absorbed, and the inflammation Conclusion:1, Cassia foam hardening agent, electrocoagulation, or both can be effectively closed. The blood vessel endothelial cell regeneration was found in the vein of the rabbit, the foam hardening agent, the electrocoagulation, or the combination of both. 3. The combined electrocoagulation of the polycinnamyl alcohol foam sclerosing agent and the electrocoagulation alone did not increase the increase of the endothelial cell by two methods.
【学位授予单位】：蚌埠医学院
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R654.4

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