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目的探讨含血栓的静脉管壁病理形态学特征及管腔内径变化。方法收集含血栓的曲张大隐静脉主干标本18例(血栓组),单纯曲张大隐静脉主干标本18例(曲张组),另设正常大隐静脉主干标本12例(对照组)。采用苏木精-伊红和Masson染色法,观察管壁组织结构,测量血管壁内径与内膜、中膜、外膜厚度。结果血栓组管壁全层及血栓内见大量炎细胞浸润,血栓附着处内皮细胞缺失,大量增生的胶原纤维自破裂内膜处延伸至血栓内致部分血栓机化。曲张组管壁全层偶见炎细胞,内膜增厚,中膜平滑肌细胞不规则增生,排列紊乱,胶原纤维增生。对照组管壁内膜薄,中膜平滑肌束排列规则。血栓组管腔内径、内膜厚度、中膜厚度和外膜厚度与曲张组、对照组比较差异均有统计学意义(P<0.05),曲张组管腔内径和内膜厚度与对照组比较差异有统计学意义(P<0.05)。结论含血栓的曲张静脉管腔增大、管壁增厚是病理形态学改变的主要特征。
Objective To investigate the pathomorphological characteristics of the venous wall with thrombus and the change of lumen diameter. Methods 18 cases of thromboembolic saphenous vein trunk specimens (thrombosis group), 18 simple varicose saphenous vein trunk specimens (varicose vein group) and 12 normal saphenous vein trunk specimens (control group) were collected. The hematoxylin-eosin and Masson staining were used to observe the tissue structure of the vessel wall, and the inner diameter of the vessel wall and the thickness of the tunica intima, tunica media and tunica adventitia were measured. Results In the thrombus group, there were a large number of infiltration of inflammatory cells in the whole layer of the wall of the thrombus and in the thrombus, the absence of endothelial cells at the site of the thrombus, and the proliferation of collagen fibers extending from the ruptured endometrium to thrombus-induced partial thrombosis. In the varicose vein group, the inflammatory cells, the thickening of the intima, the irregular proliferation of smooth muscle cells in the tunica media, the disordered arrangement and the proliferation of collagen fibers were found in all layers of the wall of the varicose vein. In the control group, the thinning of the tunica intima and the arrangement of the smooth muscle bundles in the tunica media. The diameter of thoracic cavity, the thickness of intima, the thickness of media and the thickness of adventitia in thrombosis group were significantly different from those in control group (P <0.05). The diameter of lumen and intima in varicose vein group were significantly different from that in control group There was statistical significance (P <0.05). Conclusions The lumen of varicose veins with thrombus increases, and the thickening of the wall is the main characteristic of pathological changes.