介入法犬股骨头坏死模型制作研究

发布时间：2018-03-06 10:03

本文选题：股骨头坏死　切入点：动物模型　出处：《南京医科大学》2009年硕士论文　论文类型：学位论文

【摘要】：目的:探讨运用介入方法建立犬股骨头坏死模型的可行性及造模效果,为股骨头坏死的治疗研究提供良好的模型基础。方法:9只成年健康杂种犬全麻后,分别通过股动脉Seldinger法穿刺插管,超选一侧股骨头供血动脉行平阳霉素灌注及明胶海绵栓塞处理,建立股骨头缺血坏死模型,对侧股骨头作对照。模型犬随机分为三组,每组3只,分别于栓塞术后2、4、6周处死。所有犬均于栓塞术前及术后每周予抽取外周静脉血检测血液流变学变化及行双侧髋关节MRI扫描观察股骨头影像学改变,栓塞术前、术后即刻、处死前行双侧股骨头供血动脉DSA造影检查了解栓塞侧股骨头血供情况,最后一次造影结束处死动物,取双侧股骨头标本送病理学观察。结果: (1)所有实验犬栓塞造模术后无一例发生感染或死亡,无一例出现造模侧肢体皮肤或肌肉组织坏死。术后一周内犬精神状态差,体重明显减轻,造模侧肢体呈跛行状态;一周后犬精神状态逐渐好转,造模侧肢体由跛行逐渐过渡到能着地负重,体重较前逐渐恢复。 (2)根据结果分析,造模术后实验动物的血液符合股骨头坏死发病过程中存在的高粘滞状态,表现为全血粘度、红细胞聚集性增高,红细胞变形性能力下降。血液高粘滞状态在造模术后早期、MRI尚未出现异常表现(术后3周)之前已经形成并持续存在于造模术后整个过程中。 (3)通过预试验解剖及血管造影观察,犬股骨头区血供主要来源于髂内动脉髋关节分支和骶正中动脉髋关节分支。栓塞术后即刻造影示栓塞侧股骨头供血动脉各分支远端主干均闭塞,术后2、4、6周造影复查均未见栓塞动脉再通,且栓塞动脉近端存留主干随造模后时间延长缩细程度逐渐加重,6周时造影示3只犬中2只犬出现栓塞侧骶正中动脉髋关节分支近端主干完全闭塞。 (4)MRI观察:栓塞术后3周内模型犬双侧股骨头信号与术前相比无明显差异;栓塞术后4周6只犬中4只犬栓塞侧股骨头T1、T2加权像开始表现为弥漫性不均匀高低混杂信号;栓塞术后5周、6周剩下3只犬栓塞侧股骨头T1、T2加权像均表现为不均匀混杂信号,且范围随时间延长而扩大,T1加权像以低信号为主,T2加权像以中低信号为主。 (5)组织病理学观察:栓塞术后2周出现骨髓中造血干细胞坏死,脂肪细胞增大融合、部分坏死溶解等早期病理学坏死改变;栓塞术后4周病理切片出现不同程度骨细胞及骨小梁坏死;栓塞术后6周病理切片可见坏死后增生及修复反应。结论:介入栓塞法能成功制作出犬股骨头坏死模型,具有创伤小、造模方法简单、成模时间短、动物死亡率低等优点,是一种比较理想的造模方式。
[Abstract]:Objective: to explore the feasibility and effect of establishing canine femoral head necrosis model by interventional method, and to provide a good model basis for the treatment of femoral head necrosis. Methods after general anesthesia of 9 adult healthy mongrel dogs, femoral head ischemic necrosis model was established by femoral artery Seldinger puncture and cannulation respectively. One side of femoral head feeding artery was perfused with pingyangmycin and gelatin sponge embolization was used to establish the model of avascular necrosis of femoral head. The contralateral femoral head was used as control. The model dogs were randomly divided into three groups, 3 in each group. All dogs were killed at 2 and 4 weeks after embolization. The hemorheological changes of peripheral venous blood were detected before and every week after embolization, and the imaging changes of femoral head were observed by bilateral hip MRI scanning. The changes of femoral head were observed immediately before embolization and immediately after embolization. The DSA angiography of bilateral femoral head supplying artery was performed before death to understand the blood supply of the embolized femoral head. The animals were killed at the end of the last angiography, and the specimens of bilateral femoral head were taken for pathological observation. Results:. 1) No infection or death occurred in all experimental dogs after embolization and no necrosis of skin or muscle tissue of the limb was found in all the experimental dogs. The dogs were in poor mental state and significantly reduced weight within one week after the operation, and the limb of the model side was in a limping state. One week later, the mental state of the dog gradually improved, the limb of the model was gradually transferred from limp to landing weight, and the weight gradually recovered. 2) according to the analysis of the results, the blood of the experimental animals after modeling was in accordance with the high viscosity state existing in the process of necrosis of the femoral head, showing that the whole blood viscosity and the aggregation of red blood cells were increased. The deformability of red blood cells was decreased and the hyperviscosity of blood was formed and persisted during the whole process of model making before the early stage of model making (3 weeks after operation) before the abnormal appearance of MRI was not found in the early stage of model making (3 weeks after operation). (3) Anatomy and Angiography, The blood supply in the femoral head area of dogs was mainly derived from the hip joint branch of the internal iliac artery and the hip branch of the median sacral artery. No embolization artery recanalization was found at 2 ~ 4 ~ 6 weeks after operation. And the preservation of the main trunk in the proximal end of the embolized artery was gradually aggravated with the prolongation of the duration of the model. At 6 weeks after embolization, 2 of the 3 dogs showed complete occlusion of the proximal branch of the femoral branch of the middle sacral artery in the embolized side. MRI observation showed that there was no significant difference in the signal intensity of bilateral femoral head between the two sides of the model dog within 3 weeks after embolization, and in 4 out of 6 dogs after embolization, the T _ 1 / T _ 2 weighted images of the embolized side of femoral head began to show diffuse heterogeneous mixed signal. The T _ 1 T _ 2 weighted images of the femoral head in the embolized side of the remaining 3 dogs showed inhomogeneous mixed signal at the end of 5 weeks and 6 weeks after embolization, and the range of T _ 1 weighted images increased with time, and the main T _ 1-weighted images were low and low signal intensity. (5) histopathological observation: bone marrow hematopoietic stem cell necrosis, adipocyte enlargement and fusion, partial necrolysis and other early pathological necrotic changes occurred 2 weeks after embolization. Osteocyte and trabecular necrosis were observed at 4 weeks after embolization and proliferation and repair reaction were observed in pathological sections 6 weeks after embolization. Conclusion: the canine femoral head necrosis model can be successfully made by interventional embolization, which has the advantages of small trauma, simple modeling method, short modeling time and low animal mortality. It is an ideal model making method.
【学位授予单位】：南京医科大学
【学位级别】：硕士
【学位授予年份】：2009
【分类号】：R681.8;R-332

【参考文献】