 |
 |
医学免费论文:家兔经回结肠静脉穿刺插管的实验技术研究
【摘要】 目的 优化家兔经回结肠静脉介入性穿刺插管技术。方法 经腹正中10 cm(1只)、中下腹正中4 cm(2只)、右下腹纵行4 cm(2只)切口，采用改良Seldinger技术，用5F导管鞘(2只)或10 cm长5F截短导管(3只)经回结肠静脉建立通道，实施门静脉3F导管选择性插管，比较不同切口、器材的优缺点。结果 三种切口均能较好暴露靶血管。腹正中切口操作时间较短，出血量少，切口越长暴露越好;右下腹切口操作时间较长，出血较多，靶血管暴露情况与中下腹正中4 cm切口相仿。1例右下腹纵行切口5F截短导管插管因其尖端刺破血管失败;1例腹正中10 cm切口实验兔因未采取结扎与固定丝线预防出血，术中出血较多于术后13 h死亡;另3只操作成功并存活。结论 经中下腹正中4 cm切口，正确防治出血并发症，使用5F导管鞘，可较好地保证家兔经回结肠静脉穿刺插管的安全性和可操作性。
【关键词】 兔; 回结肠静脉; 门静脉; 介入放射学; Seldinger技术医.学全.在.线网站www.med126.com
Research on technology of catheterization via ileocolic vein in rabbitsWU Shaoping1,HU Yang2,ZHANG Zhi1,LIU Yabin1,LIU Shulin1,ZHANG Xiaoqin2,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 flowsheet of portal vein catheterization via ileocolic vein in rabbits.Methods After lowerright or median abdominal incision(4 or 10 cm)，catheterization of 3F catheter were inserted into hepatic portal vein system via 5F homemade 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 lowerright 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 lowerright abdominal incision was failed because the cacumen of 5F homemade 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
剖腹经回结肠静脉穿刺插管是门静脉系统相关实验研究的常用技术[13]，在肝硬化、肝癌等疾病临床与基础研究中具有重要价值[4,5]。已有的兔门静脉插管相关文献中，其实验方法介绍简略，无规范化操作参考[68]。为此，我们以健康成年家兔为对象，比较中下腹正中、右下腹(更接近回结肠区域)纵行切口两种剖腹路径和5F导管鞘、10 cm长5F截短导管两种插管器材的实验操作结果，以探索该实验的优化流程及技术要点。
1 对象与方法
1.1 主要器材GE1250 LCE+ DSA、5F穿刺套装、自制5F10 cm长直头截短导管、自制兔实验台、三通管、5 kg弹簧称、摄子、止血钳、组织剪、手术刀柄及刀片、2 ml及5 ml注射器、7号及4号医用缝合丝线、缝合针、纱布、3%戊巴比妥纳、碘海醇(扬子江药业集团有限公司产，100 ml/30 g.I)、肝素钠注射液、医用碘酒、酒精、生理盐水等。
