一个组织学和免疫化学研究,比较开放式与闭合式和开放式方法的内镜软静脉采集
Sivakumar Krishnasamy1, Raja Amin Raja Mokhtar1, Ahmad Farouk Musa2
1Cardiothoracic Division, Universiti Malaya, Kuala Lumpur, Malaysia.
Indian journal of thoracic and cardiovascular surgery
|August 19, 2024
概括
开放的二氧化碳内镜软静脉采集 (ESVH) 会导致更多的内皮细胞脱离. 与开放式和封闭式CO2 ESVH技术相比,开放式安全静脉采集 (OSVH) 显示出更好的内皮保护.
科学领域:
- 血管外科 血管外科
- 手术技巧 手术技巧
- 组织病理学 组织病理学
背景情况:
- 内镜软静脉采摘 (ESVH) 对于其对伤口并发症的影响进行了辩论.
- 之前的报道表明,ESVH可以减少疼痛和感染,而不是开放的软静脉收获 (OSVH).
- 内皮质的保存是移植通透性和长期结果的关键因素.
研究的目的:
- 为了比较使用不同的技术收获的软静脉 (SV) 接种中的内皮保护.
- 评估收获方法,二氧化碳吸入和静脉张张对内皮完整性的影响.
- 评估与每个技术相关的收获时间,关闭时间和切口长度.
主要方法:
- 一项前性观察性研究,涉及60个人类软静脉移植.
- 通过封闭的CO2 ESVH,开放的CO2 ESVH或OSVH收获的沙静脉.
- 使用血素-氨酸和CD31染色评估内皮质的保存;高分辨率幻灯片扫描.
主要成果:
- 开放式CO2ESVH显示了最高的内皮脱落率和最低的CD31分数 (33.25%).
- 这两种ESVH方法都比OSVH更短的收获/关闭时间和更小的切口.
- 分散静脉的CD31分数显著降低 (39.0%),表明内皮质保存较差.
结论:
- 开放式CO2ESVH与因可视化和引应力而增加的内皮细胞脱离有关.
- 封闭的CO2ESVH方法比开放的CO2方法保留了更多的内皮细胞.
- 开放的沙静脉采集 (OSVH) 提供了最好的内皮细胞保存,细胞脱落最少,CD31得分最高.
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