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目的应用不同直径和压力的球囊扩张血管后,观察其管壁结构的变化。方法应用扩张球囊给予不同压力和不同扩张直径对游离猪的中小动脉血管进行持续扩张,随后进行肉眼、光镜及透射电镜检查。结果在6个大气压扩张作用下,血管内膜部分脱失,中膜平滑肌层部分撕脱,内皮细胞与内弹力板层分离。在7个大气压球囊作用下,血管径增加10%,血管内膜不完整,中膜肌层可见撕裂,内弹力板断裂。在8个大气压球囊作用下,血管径增加15%,血管内膜不完整,中膜肌层可见撕裂。在9个大气压球囊扩张下,血管径增加15%,血管内膜层损伤更完全。在直径为2倍的球囊扩张作用下,血管内膜部分脱失,内皮细胞部分细胞器脱出。在直径为3倍的球囊扩张作用下,血管管径增宽1倍,血管内膜不完整,中膜肌层撕裂,内弹力板断裂。在直径为4倍的球囊扩张下,血管壁破裂,血管变形,血管内膜基本消失,中膜肌层普遍断裂并累及外膜肌层。结论血管壁损伤随球囊给予血管的压力及直径的增加而增加,压力作用和成倍扩张血管对血管壁的损坏具有相辅相成的关系,并且压力的作用大于血管径扩张的作用。
Objective To observe the changes of the wall structure of the balloon after balloon dilatation with different diameters and pressures. Methods The dilated balloon was used to expand the small and medium-sized arteries of free pigs under different pressures and different diameters of expansion, followed by macroscopic examination, light microscopy and transmission electron microscopy. Results Under the action of 6 atm expansion, part of the intima of the blood vessel was lost, part of the tunica intima was avulsion, and the endothelial cells were separated from the internal elastic lamina. Under the action of 7-atmosphere balloon, blood vessel diameter increased by 10%, intima-media invagination, torn in medial myometrium, and rupture in the inner elastic membrane. Under the action of 8-atmosphere balloon, the diameter of the blood vessel increased by 15%, the intima of the blood vessel was incomplete, and the tear of the myometrium was visible. Under 9-atmosphere balloon dilatation, the diameter of the blood vessel increased by 15% and the injury to the vascular intima more completely. In the diameter of 2 times the balloon dilatation, part of the vascular intima loss, endothelial cell organelles prolapse. In the diameter of 3 times the balloon dilatation, the vascular diameter broadened 1 times, intima-media intima-media tear, the inner elastic plate rupture. In 4-fold diameter balloon dilatation, ruptured vessel wall, vascular deformation, vascular intima almost disappeared, the common myometrial rupture and involvement of the outer myometrium. Conclusion The damage of vessel wall increases with the increase of pressure and diameter of blood vessel. The pressure effect and dilatation of blood vessels have the relationship of blood vessel wall damage, and the effect of pressure is larger than the expansion of blood vessel diameter.