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KMID : 0358819870140010023
대한성형외과학회지
1987년 14권 1호 p.23 ~ p.30
미세혈관문합때 염산 Ticlopidine의 항혈전 효과
ANTITHROMBOTIC EFFECT OF TICLOPIDINE-HCL IN MICRO VASCULAR ANASTOMOSES
전종완 ( Jeon Jong-Wan ) - 계명대학교 의과대학 성형외과학교실

한기환 ( Han Ki-Hwan ) - 계명대학교 의과대학 성형외과학교실
강진성 ( Kang Jin-Sung ) - 계명대학교 의과대학 성형외과학교실
김선영 ( Kim Sun-Young ) - 계명대학교 의과대학 병리과학교실
정재홍 ( Chung Chai-Hong ) - 계명대학교 의과대학 병리학교실
- Abstract -
저자들은 흰쥐 120마리를 대조군, ticlopidine군, aspirin-persantin군으로 나누어 미세문합술을 시행한 다음 20분, 3일, 3주에 육안적, 조직학적으로 개존율을 관찰하여 다음과 같은 결과를 얻었다.
1. 문합후 20분에는 모든 군에서 동ㆍ정맥 공히 100%의 개존율을 보였다.
2. 문합후 3일에 동맥에서는 각 군간에 유의한 차이가 없으나 정맥에서 ticlopidine은 대조군에 비해 훨씬 높은 개존율을 보이고 aspirin-persantin군에 비해서도 약간 높은 경향을 보여 주었다.
3 문합후 3주에 동ㆍ정맥 모두에서 ticlopidine군은 aspirin-persantine군과 차이는 미미 하였으나 대조군에 비해서는 훨씬 높은 개존율을 보여주는 경향이었다.
4. 각 군간에 조직학적인 차이는 없었고, 개존율은 육안으로나 광학현미경으로 얻은 성적이 동일하였다.
Recent progress in microvascular surgery has opened new clinical possibilities in tissue transplantation and replantation by direct anastomoses of vessels less than one mm in external diameter. However, a large obstacle still remains in microsurgery, that is, occlusion of the anastomosis site by thrombosis which is mainly composed of platelets. Many anticoagulants and topical vasodilatic agents such as heparin, aspirin, persantin, coumarin and magnesium sulfate have been used to solve this problem.

Heparin inhibits the conversion of prothrombin to thrombin and Factos Ⅴ,Ⅸ,--, Aspirin inhibits collagen-induced platelet aggregation whereas the primary action of persantin is to inhibit ADP-induced platelet aggregation and the release reaction of platelets. Currently, ticlopidine-HCI which is known to inhibit the platelet aggregation to ADP, collagen and epinephrine, is widely in use as an effective anticoagulant for the patients of atherosclerosis, hemodialysis, and subarachoid hemorrhage.

Animal study was carried out for the ticlopidine-HCI to investigate the possibility of this agent to be used as a choice of anticoagulant in microvascular surgery. One hundred and twenty rats were divided into 3 groups. Group A was the control group. Aspirin and persantin were given orally in group B. Ticlopidine-HCI was given orally in group C. A femoral artery in one inguinal region and one femoral vein in the other side were severed and then were anastomosed with 10-0 nylon. The wounds were closed with 4-0 black silk. The patency was confirmed grossly and microscopically at 20 minutes, 3 days, and 3 weeks after anastomoses. The patency rates were as follows:

1. At 20 minutes after anstomoses, patency rates of arteries and veins were 100% in all groups.

2. At 3 days after anastomoses, in the control group the patency rates of arteries and veins were 95% and 85% respectively. Group B (aspirin-persantin)were 100% and 90% each. Compared with these, the patency rates of group C (ticlopidine) were better, all of the arteries and veins were patent.

3. At 3 weeks after anastomoses, the patency rates of arteries were 90% and veins were 80% in the control group. Arteries were 95% and veins were 90% in group B, whereas arteries were 100% and veins were 95% in group. C.

Therefore, it is concluded that the ticlopidine can be used in microvasular surgery as an anticoagulant of choice.
- Key Words -

- 원문 및 링크아웃 정보 -
- 등재저널 정보 -
학술진흥재단(KCI) KoreaMed 대한의학회 회원