超声引导下兔体内直接性门腔静脉分流支架植入术的可行性与安全性

发布时间：2018-02-24 12:26

本文关键词： 超声检查引导直接性门腔静脉分流术下腔静脉肝后段动物实验兔　出处：《中国介入影像与治疗学》2015年06期 　论文类型：期刊论文

【摘要】：目的探讨超声引导下经皮穿刺门静脉右支(RPV)与肝后段下腔静脉(RHSIVC),行直接性门腔分流支架植入术的可行性与安全性。方法超声引导下对10只实验兔经皮穿刺RPV,调整穿刺针角度后,穿刺RHSIVC,送入导丝并沿导丝放入支架,建立直接性门腔分流通道,观察实验兔支架内血流充盈情况,并测量血流速度。术后30min解剖实验兔,观察支架位置及是否存在肝包膜下出血、腹腔大血管及周围脏器损伤等并发症。结果对9只实验兔成功实施超声引导下直接性门腔静脉分流支架植入术,另1只因术中下腔静脉出血过多致死。超声所测平均RPV内径为(0.23±0.02)cm,RHSIVC内径为(0.38±0.05)cm,RPV与RHSIVC之间平均角度为(22.38±1.60)°;平均穿刺时间(11.4±3.69)min,穿刺RPV、RHSIVC平均次数分别为(1.30±0.48)次和(1.50±0.71)次,平均支架长度(1.06±0.09)cm,支架内平均血流速度(8.14±0.89)cm/s。术后大体解剖结果显示,除1只死亡外,9只实验兔支架均位于RPV与RHSIVC之间的肝实质内,且未出现肝包膜下出血、腹腔大血管及周围脏器损伤等并发症。结论超声引导下兔体内直接性门腔静脉分流支架植入术具有一定的安全性及可行性。
[Abstract]:Objective to investigate the feasibility and safety of percutaneous percutaneous puncture of right portal vein (RPVV) and posterior inferior hepatic vena cava (RHSIVCU) with direct portal shunt stent implantation under the guidance of ultrasound in 10 experimental rabbits. RHSIVC was punctured and inserted into the stent along the guide wire to establish a direct portal shunt channel. The filling of blood flow in the stent was observed and the blood flow velocity was measured. The experimental rabbits were dissected 30 minutes after operation. To observe the location of stent and whether there were complications such as hepatic subcapsular hemorrhage, injury of abdominal great vessels and surrounding organs, etc. Results the direct portal vena cava shunt stent implantation was successfully performed on 9 experimental rabbits under the guidance of ultrasound. The average internal diameter of RPV was 0.38 卤0.05 cm ~ (-1) and the mean angle between RHSIVC and RHSIVC was 0.38 卤1.60) 掳, the mean puncture time was 11.4 卤3.69 min, the average times of puncture were 1.30 卤0.48) times and 1.50 卤0.71) times respectively, the average diameter of RHSIVC was 0.23 卤0.02cm ~ (-1) and 1.50 卤0.71) times respectively, and the mean time of puncture was 11.4 卤3.69 min, and the mean internal diameter of RHSIVC was 1.30 卤0.48 times and 1.50 卤0.71 times, respectively, and the mean time of puncture was 1.30 卤0.48 times and 1.50 卤0.71 times respectively. The mean stent length was 1.06 卤0.09 cm, and the mean blood flow velocity was 8.14 卤0.89 cm / s. The postoperative gross anatomical results showed that all the stents were located in the hepatic parenchyma between RPV and RHSIVC, and there was no subcapsular hemorrhage. Conclusion Ultrasound-guided direct portal vena cava shunt stent implantation is safe and feasible.
【作者单位】：中国人民解放军空军总医院超声科;
【分类号】：R-332;R445.1

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