醫(yī)學(xué)免費論文:家兔經(jīng)回結(jié)腸靜脈穿刺插管的實驗技術(shù)研究

醫(yī)學(xué)免費論文:家兔經(jīng)回結(jié)腸靜脈穿刺插管的實驗技術(shù)研究

【摘要】 目的 優(yōu)化家兔經(jīng)回結(jié)腸靜脈介入性穿刺插管技術(shù)。方法 經(jīng)腹正中10 cm(1只)、中下腹正中4 cm(2只)、右下腹縱行4 cm(2只)切口，采用改良Seldinger技術(shù)，用5F導(dǎo)管鞘(2只)或10 cm長5F截短導(dǎo)管(3只)經(jīng)回結(jié)腸靜脈建立通道，實施門靜脈3F導(dǎo)管選擇性插管，比較不同切口、器材的優(yōu)缺點。結(jié)果 三種切口均能較好暴露靶血管。腹正中切口操作時間較短，出血量少，切口越長暴露越好;右下腹切口操作時間較長，出血較多，靶血管暴露情況與中下腹正中4 cm切口相仿。1例右下腹縱行切口5F截短導(dǎo)管插管因其尖端刺破血管失敗;1例腹正中10 cm切口實驗兔因未采取結(jié)扎與固定絲線預(yù)防出血，術(shù)中出血較多于術(shù)后13 h死亡;另3只操作成功并存活。結(jié)論 經(jīng)中下腹正中4 cm切口，正確防治出血并發(fā)癥，使用5F導(dǎo)管鞘，可較好地保證家兔經(jīng)回結(jié)腸靜脈穿刺插管的安全性和可操作性。

【關(guān)鍵詞】 兔; 回結(jié)腸靜脈; 門靜脈; 介入放射學(xué); Seldinger技術(shù)醫(yī).學(xué)全.在.線網(wǎng)站bhskgw.cn

Research on technology of catheterization via ileocolic vein in rabbitsWU Shao�瞤ing1,HU Yang2,ZHANG Zhi1,LIU Ya�瞓in1,LIU Shu�瞝in1,ZHANG Xiao�瞦in2,BAI Chen1(1. Department of Radiology, First Affiliated Hospital of Chengdu Medical College, Chengdu 610500, China;2. Department of Medical Imaging, Grade 2004, Chengdu Medical College, Chengdu 610083, China)【Abstract】 Objective To summarize the experiences and operation flow�瞫heet of portal vein catheterization via ileocolic vein in rabbits.Methods After lower�瞨ight or median abdominal incision(4 or 10 cm)，catheterization of 3F catheter were inserted into hepatic portal vein system via 5F home�瞞ade catheter or 5F catheter introducer using Seldinger technique.Results The abdominal incisions were all healed 5 days later except for the first rabbit died 13 hours after underwent 10 cm median abdominal incision.More haemorrhage occurred in rabbits via lower�瞨ight abdominal incision，and more time was spent in this way and via 10 cm median abdominal incision.The ileocolic veins were easily uncovered in all 5 rabbits. However, the catheterization in a rabbit via lower�瞨ight abdominal incision was failed because the cacumen of 5F home�瞞ade catheter pieced blood vessels. Conclusion Under the right management of haemorrhage prevention，the catheterization with 5F catheter introducer via 4 cm median abdominal incision maybe a suitable project for portal vein interventional radiology research in rabbits.【Key words】 rabbit; ileocolic vein; portal vein; interventional radiology; Seldinger technique

剖腹經(jīng)回結(jié)腸靜脈穿刺插管是門靜脈系統(tǒng)相關(guān)實驗研究的常用技術(shù)[1��3]，在肝硬化、肝癌等疾病臨床與基礎(chǔ)研究中具有重要價值[4,5]。已有的兔門靜脈插管相關(guān)文獻中，其實驗方法介紹簡略，無規(guī)范化操作參考[6��8]。為此，我們以健康成年家兔為對象，比較中下腹正中、右下腹(更接近回結(jié)腸區(qū)域)縱行切口兩種剖腹路徑和5F導(dǎo)管鞘、10 cm長5F截短導(dǎo)管兩種插管器材的實驗操作結(jié)果，以探索該實驗的優(yōu)化流程及技術(shù)要點。

1 對象與方法

1.1 主要器材GE1250 LCE+ DSA、5F穿刺套裝、自制5F10 cm長直頭截短導(dǎo)管、自制兔實驗臺、三通管、5 kg彈簧稱、攝子、止血鉗、組織剪、手術(shù)刀柄及刀片、2 ml及5 ml注射器、7號及4號醫(yī)用縫合絲線、縫合針、紗布、3%戊巴比妥納、碘海醇(揚子江藥業(yè)集團有限公司產(chǎn)，100 ml/30 g.I)、肝素鈉注射液、醫(yī)用碘酒、酒精、生理鹽水等。

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