미세혈관문합시 헤파린의 국소 및 전신 투여가 혈전 형성에 미치는 영향

EEFFECTS OF TOPICAL AND INTRAVENOUS HEPARIN ON THROMBOSIS OF MICROVASCULAR ANASTOMOSES

This study was performed to evaluate the effect of topical and intravenous heparin on thrombosis and patency in the microvascular anastomosis of the traumatized veins. Nine white rabbits weighing about 2 ㎏ were used. After exposure of both femoral veins, the veins were crushed by the jaws of smooth needle holder in order to create a thrombosis model. Transectional incision was made in the vein. The animals were then divided into 3 groups based on the administration method of heparin: 1) Experimental Group I, topical irrigation of lumen with heparin saline solution (n=6); 2) Experimental Group 2, topical irrigation of lumen with heparin saline solution and intravenous injection of heparin (0.75 mg/kg) via the marginal ear vein for 3 days; 3) Control Group, topical irrigation of lumen with saline solution (n=6). The patency was evaluated with empty-and-refill test and thrombus formation was judged by surgical microscope. The results were as follows: 1. Thirty minutes after microvascular anastomosis, the patency of all Experimental Groups was better than Control group. However, there was no significant difference among groups. 2. Three days after anastomosis, the patency of all Experimental Groups was much more improved than that of Control Group(P<0.05). There was no significant difference between Experimental Group 1 and 2. 3. Three days after anastomosis, the amount of thrombus in all Experimental Groups was much less than that of Control Group(P<0.05). 4. In histologic findings a lot of luminal thrombus were observed around sutured area in Control Groups. Few luminal thrombus was observed in all Experimental Groups. Mild necrosis in the vessel wall was observed around sutured area in all specimens. These results indicate that topical irrigation of heparin may improve the patency and inhibit the formation thrombus in the microvascular anastomosis of the traumatized veins.