医用粘合剂在血管吻合及修复中应用的研究进展

doi:10.3969/j.issn.1009-976X.2016.01.030

摘要/Abstract

摘要： 【摘要】〓血管吻合术是血管外科、显微外科、心血管外科、器官移植手术的基石,血管吻合的质量关系到整个手术的成败。血管吻合及修复的主要目标是使吻合或修复血管获得最大的近期和远期通畅率,最大化的减少对血管壁的损伤则是提高血管通畅率的重要手段。近年来,新的血管吻合方法和吻合材料不断得到报道,其中利用医用粘合剂行血管吻合术血管修复具有一定优势,对血管壁无透壁性损伤,吻合口局部血流动力学影响小,内皮化更易完成。相对于其他血管吻合方法,医用粘合剂行血管吻合或修复能缩短手术时间、减少围手术期出血、具有更好的组织相容性。本文根据其来源、粘合机制、临床运用、研究进展做一简要综述。

关键词: 血管吻合, 光敏组织化学粘合剂, 医用粘合剂, 血管外科, 纤维蛋白原, 氰基丙烯酸酯

Abstract: 【Abstract】 Vascular anastomosis is the cornerstone of vascular, microsurgery, cardiovascular and transplant surgery. The quality of anastomosis determines the success of the whole surgery. The main aim of performing a vascular anastomosis is to achieve maximal patency rates. An important factor to achieve that goal is to minimize damage to the vessel walls. In recent years, many new methods of vascular anastomosis and materials are being reported, and the utilize of medical adhesives in vascular anastomosis and vascular repair has certain advantages.Because of no permeability damage of vessel wall,small effect of anastomosis haemodynamics,endothelialization are more easily to complete. Compared to other methods of vascular anastomosis,using medical adhesives in vascular anastomosis and vascular repair can shorten the operation time,reduce perioperative bleeding,has better histocompatibility.According to its source,bonding mechanism,clinical application and research progress, the present article make a brief review.

Key words: Medicinal adhesive, Fibrinogen, Vascular Surgery, Photochemical tissue bonding, Cyanoacrylate, Vascular repair

中图分类号:

R654.3

侯彪谢松林. 医用粘合剂在血管吻合及修复中应用的研究进展[J]. 岭南现代临床外科, 2016, 16(01): 115-118.

HOU Biao, XIE Songlin. The development of medical adhesive for vascular anastomosis and repair[J]. Lingnan Modern Clinics in Surgery, 2016, 16(01): 115-118.

参考文献

[1] Bot G M, Bot K G, et al.The use of cyanoacrylate in surgical anastomosis: an alternative to microsurgery. J Surg Tech Case Rep, 2010, 2: 44-48.
[2] Wippermann J, Konstas C, et al.Long-term effects in distal coronary anastomoses using different adhesives in a porcine off-pump model. J Thorac Cardiovasc Surg, 2006, 132:325-331.
[3] 宋庆伟, 杨广林.血管吻合方法的研究进展. 实用医学志, 2010, 26: 515-517.
[4] Coover HN, Joyner FB, et al.Chemistry and performance of a cyanoacrylate adhesive. Spec Tech Pap, 1959, 5: 413–417.
[5] 罗洁, 王凤山.医用软组织粘合剂的研究进展及临床应用现状. 药物生物技术, 2014, 21: 274-278.
[6] Gottlob R, Blümel G.Anastomoses of small arteries and veins by means of bushings and adhesive . J Cardiovasc Surg (Torino), 1968, 9: 337-341.
[7] Green AR, Milling MA, et al.Butylcyanoacrylate adhesives in microvascular surgery: an experimental pilot study. J Reconstr Microsurg, 1986, 2: 103-105.
[8] Hall WW, Wrye SW, et al.Microvascular anastomosis using 2-octyl cyanoacrylate in the rat femoral artery. Ann Plast Surg, 2000, 44: 508-511.
[9] Ang ES, Tan KC, et al.2-octylcyanoacrylate-assisted microvascular anastomosis: Comparison with a conventional suture technique in rat femoral arteries. J Reconstr Microsurg, 2001, 17: 193–201.
[10] Ng YS, Yap K, et al.2-Octylcynanoacrylate-assisted microvascular anastomosis in a rat model: Long-term biomechanical properties and histological changes. Microsurgery, 2004, 24: 304–308.
[11] Lumsden AB, Heyman ER, et al.Prospective randomized study evaluating an absorbable cyanoacrylate for use in vascular reconstructions. J Vasc Surg, 2006, 44: 1002-1009.
[12] Schwaiger N, Wu J, et al.BioWeld(?) Tube and surgical glue for experimental sutureless venous microanastomosis. Br J Surg, 2010, 97: 1825-1830.
[13] Chang EI, Galvez MG, et al.Vascular anastomosis using controlled phase transitions in poloxamer gels. Nat Med, 2011, 17: 1147-1152.
[14] Zhao YZ, Lv HF, et al.Evaluation of a novel thermosensitive heparin-poloxamer hydrogel for improving vascular anastomosis quality and safety in a rabbit model. PLoS One, 2013, 8: e73178. Lang [15] Lang N, Pereira MJ, et al. A blood-resistant surgical glue for minimally invasive repair of vessels and heart defects. Sci Transl Med, 2014, 6: 218ra6.
[15] Spotnitz WD.Fibrin Sealant: The Only Approved Hemostat, Sealant, and Adhesive-a Laboratory and Clinical Perspective. ISRN Surg, 2014, 2014: 203943.
[16] Spotnitz WD, Prabhu R.Fibrin sealant tissue adhesive--review and update. J Long Term Eff Med Implants, 2005, 15: 245-270.
[17] Kheirabadi BS, Field-Ridley A, et al.Comparative study of the efficacy of the common topical hemostatic agents with fibrin sealant in a rabbit aortic anastomosis model. J Surg Res, 2002, 106: 99-107.
[18] Dickneite G, Metzner H.Prevention of suture hole bleeding using fibrin sealant: benefits of factor XIII. J Surg Res, 2000, 93: 201-205.
[19] Taylor LM Jr, Mueller-Velten G, et al.Prospective randomized multicenter trial of fibrin sealant versus thrombin-soaked gelatin sponge for suture- or needle-hole bleeding from polytetrafluoroethylene femoral artery grafts. J Vasc Surg, 2003, 38: 766-771.
[20] Stooker W, Niessen HW, et al.Perivenous application of fibrin glue reduces early injury to the human saphenous vein graft wall in an ex vivo model. Eur J Cardiothorac Surg, 2002, 21: 212-217.
[21] Sacak B, Tosun U, et al.Two-suture fish-mouth end-to-side microvascular anastomosis with fibrin glue. J Craniofac Surg, 2012, 23: 1120-1124.
[22] Oyama H, Kito A, et al.Repair of carotid blow-out using a carotid sheath in a patient with recurrent thyroid cancer. Nagoya J Med Sci, 2012, 74: 193-198.
[23] Mehdi Rasti Ardakani, Abdoljalil Kalantar Hormozi, et al.Introduction of a potent single-donor fibrin glue for vascular anastomosis: An animal study. J Res Med Sci, 2012, 17: 461–465.
[24] Sacak B, Tosun U, et al.Microvascular anastomosis using fibrin glue and venous cuff in rat carotid artery. J Plast Surg Hand Surg, 2015, 49: 72-76.
[25] Pratt GF, Rozen WM, et al.Technology-assisted and sutureless microvascular anastomoses: evidence for current techniques. Microsurgery, 2012, 32: 68-76.
[26] Gruber-Blum S, Petter-Puchner AH, et al.A comparison of a bovine albumin/glutaraldehyde glue versus fibrin sealant for hernia mesh fixation in experimental onlay and IPOM repair in rats. Surg Endosc, 2010, 24: 3086-3094.
[27] Gundry SR, Black K, et al.Sutureless coronary artery bypass with biologic glued anastomoses: preliminary in vivo and in vitro results. J Thorac Cardiovasc Surg, 2000, 120: 473-477.
[28] R?tker J, Tr?sch F, et al.Vascular anastomosing by gluing--an experimental study. Thorac Cardiovasc Surg, 2004, 52: 6-9.
[29] Schiller W, Rudorf H, et al.Short-term tissue response of lapine carotid artery microanastomoses to BioGlue. Thorac Cardiovasc Surg, 2007, 55: 298-303.
[30] Schiller W, Rudorf H, et al.Sutureless anastomoses of rabbit carotid arteries with BioGlue. J Thorac Cardiovasc Surg, 2007, 134: 1513-1518.
[31] Vokrri L, Qavdarbasha A, et al.Experimental study of sutureless vascular anastomosis with use of glued prosthesis in rabbits. Vasc Health Risk Manag, 2015, 11 :211-217.
[32] Gaberel T, Borgey F, et al.Surgical site infection associated with the use of bovine serum albumine-glutaraldehyde surgical adhesive (BioGlue) in cranial surgery: a case-control study. Acta Neurochir (Wien), 2011, 153: 156-162.
[33] Johnson TS, O'Neill AC, et al.Photochemical tissue bonding: a promising technique for peripheral nerve repair. J Surg Res, 2007, 143: 224-229.
[34] O'Neill AC, Winograd JM, et al.Microvascular anastomosis using a photochemical tissue bonding technique. Lasers Surg Med, 2007, 39: 716-722.