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目的建立犬嫁接性梭形动脉瘤模型,高频超声(high-frequency ultrasound,HFUS)观察模型的长期可靠性,光镜与透射电镜(TEM)评价模型的病理学特征。方法 10只犬采用全麻和显微外科的方法,将双侧的颈外静脉剥离外膜后,取1.5cm嫁接同侧颈总动脉制作梭形动脉瘤模型20枚;术后第2、4、12周分别进行HFUS检测血管参数;术后6、12、24周分别选择2只犬的4枚动脉瘤模型解剖后进行病理学观察;其余4只犬继续观察至24个月。结果 10只犬全部存活,术后经HFUS观察:共收获大小相似的梭形动脉瘤模型20枚(成模率达100%),瘤腔内为涡流,术后12周模型膨胀性增大,并具有自发破裂的趋势;HFUS可清晰地显示动脉瘤壁的内膜增厚、增生斑块和钙化;模型的病理学观察显示:在血流动力学作用下,6、12周,瘤壁以损伤、应激增生为主;24周瘤壁以适应性重塑为主。术后12个月发现1枚动脉瘤自发破裂并闭塞,病理学显示瘤壁多层次出血、内膜崩裂、远端吻合口斑块钙化、脱落,瘤腔内多层次血栓闭塞。长达24个月的观察表明:破裂梭形动脉瘤模型的血流动力学作用机制和病理学特征,与人体真正的颅内动脉瘤生理特性相符合。结论犬嫁接性梭形动脉瘤模型制作简便、可重复性强、稳定可靠。
OBJECTIVE: To establish a long-term reliability model of canine grafts, evaluate the long-term reliability of the model by high-frequency ultrasound (HFUS), and evaluate the pathological features of the model by light and transmission electron microscopy (TEM). Methods Ten dogs were treated with general anesthesia and microsurgery. Two sides of the external jugular vein were dissected from the adventitia, and 1.5 cm grafts of ipsilateral common carotid artery were used to make 20 models of spindle aneurysms. , 12 weeks of HFUS vascular parameters were measured; 6,12,24 weeks after surgery, two dogs were selected 4 aneurysm model dissected pathological observation; the remaining 4 dogs were observed until 24 months. Results All the 10 dogs survived and were observed by HFUS after surgery. Twenty shuttle fusiform aneurysms of similar size were harvested (the rate of formation was 100%). The vasospasm was vortex in the tumor cavity. After 12 weeks, the expansibility of the model was increased, HFUS can clearly show the aneurysmal wall intimal thickening, plaque and calcification; pathological observation of the model showed: under hemodynamic effects, 6,12 weeks, the tumor wall to Injury and stress hyperplasia; 24-week tumor wall to adapt to the main remodeling. One aneurysm ruptured and occluded at 12 months after operation. The pathological findings showed multiple layers of hemorrhage in the tumor wall, rupture of the endometrium, calcification of distal anastomotic plaque, loss of the tumor, and multi-level thromboembolism in the tumor cavity. The 24-month observation shows that the hemodynamic mechanism and pathological features of the ruptured fusiform aneurysm model are consistent with the true physiological characteristics of human intracranial aneurysms. Conclusions Canine grafting spindle tumor aneurysm model is simple, reproducible, stable and reliable.