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醫(yī)學(xué)免費(fèi)論文:家兔經(jīng)回結(jié)腸靜脈穿刺插管的實(shí)驗(yàn)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(zhǎng)5F截短導(dǎo)管(3只)經(jīng)回結(jié)腸靜脈建立通道，實(shí)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(diǎn)。結(jié)果 三種切口均能較好暴露靶血管。腹正中切口操作時(shí)間較短，出血量少，切口越長(zhǎng)暴露越好;右下腹切口操作時(shí)間較長(zhǎng)，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(shí)驗(yàn)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www.gydjdsj.org.cn
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
剖腹經(jīng)回結(jié)腸靜脈穿刺插管是門靜脈系統(tǒng)相關(guān)實(shí)驗(yàn)研究的常用技術(shù)[13]，在肝硬化、肝癌等疾病臨床與基礎(chǔ)研究中具有重要價(jià)值[4,5]。已有的兔門靜脈插管相關(guān)文獻(xiàn)中，其實(shí)驗(yàn)方法介紹簡(jiǎn)略，無規(guī)范化操作參考[68]。為此，我們以健康成年家兔為對(duì)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(zhǎng)5F截短導(dǎo)管兩種插管器材的實(shí)驗(yàn)操作結(jié)果，以探索該實(shí)驗(yàn)的優(yōu)化流程及技術(shù)要點(diǎn)。
1 對(duì)象與方法
1.1 主要器材GE1250 LCE+ DSA、5F穿刺套裝、自制5F10 cm長(zhǎng)直頭截短導(dǎo)管、自制兔實(shí)驗(yàn)臺(tái)、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(hào)及4號(hào)醫(yī)用縫合絲線、縫合針、紗布、3%戊巴比妥納、碘海醇(揚(yáng)子江藥業(yè)集團(tuán)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。
