猪房间隔缺损模型制作的实验研究

发布时间：2018-06-17 13:46

本文选题：房间隔缺损 + 房间隔穿刺术　；参考：《昆明医学院》2010年硕士论文

【摘要】： 【目的】:通过X线下介入导管的方法经右侧颈外静脉行房间隔穿刺及球囊扩张术建立猪房间隔缺损动物模型,通过右心导管测压和心脏超声等手段评估模型制作的可行性,观察不同时期血流动力学和心脏结构的变化。【方法】:选用由昆明医学院提供的封闭群滇南小耳猪16头,平均月龄9-10月,体重18-25公斤,雌雄不限。按体重相近随机将16头猪分为两组,组一:n=4,行房间隔穿刺术;组二:n=12,在成功行房间隔穿刺术的基础上,分别采用0.8cm,1.5cm直径大小的扩张球囊先后对房间隔缺损口扩张。将组二随机再分成A,B两组,每组6头,A组经颈外静脉途径建立模型,B组经股静脉途径建立模型。模型建立后比较两种方法在手术时间和X线暴露时间上的差异,动态观察实验猪的一般情况,分别于术前,术后即刻,术后1月及术后3月通过有创压力检测和心脏超声的方法观察血流动力学和心脏结构的变化。【结果】:16头健康实验猪,1头死于术中急性心包填塞,3头猪成功行房间隔穿刺术,术后即刻,术后3月经心脏超声和心脏解剖证实缺损口闭合;其余12头猪分别经颈外静脉或股静脉途径在成功行房间隔穿刺术基础上用0.8cm,1.5cm直径大小的球囊行球囊扩张术成功建立动物模型,除1头在手术后因感染死亡外,其余11头存活,分别在术后即刻,术后1月,术后3月经心脏超声和心脏解剖证实缺损口直径大小为1.16±0.15cm,1.01±0.14cm,0.91±0.14cm。颈外静脉途径建立猪房间隔缺损模型在手术时间和X线暴露时间方面短于股静脉途径。有创压力监测显示术后3月与术前比较,平均肺动脉压(MPAP),右心室压力(RVP),右心房压力(RAP)差异有显著性统计学意义(P＜0.01),心脏超声显示术后3月与术前比较,右心房内径(RA),右心室内径(RV),左心房内径(LA)差异有显著统计学意义(P＜0.01),术后3月行病理检查发现疤痕组织形成,心肌细胞排列整齐,未见明显的细胞变性,坏死和纤维组织增生,肺小动脉管腔大小正常,无肌化表现。【结论】:经颈外静脉行房间隔穿刺术及球囊扩张术制作猪房间隔缺损动物模型是一种有效,简便,微创,可重复的方法。经颈外静脉途径行猪房间隔缺损动物模型的制作方法在手术时间和X线暴露时间方面短于经股静脉途径猪房间隔缺损动物模型的制作。猪房间隔缺动物模型主要影响了右心系统的血液动力学及心脏形态的变化,是建立左向右分流型肺动脉高压模型的方法之一。
[Abstract]:[objective] to establish an animal model of atrial septal defect (ASD) by transcatheter interventional catheter through right external jugular vein and balloon dilatation, and to evaluate the feasibility of the model by right cardiac catheterization and echocardiography. The changes of hemodynamics and cardiac structure in different periods were observed. [methods] Sixteen small Diannan small ear pigs, which were provided by Kunming Medical College, were selected, with an average age of 9-10 months and weight of 18-25 kg. Sixteen pigs were randomly divided into two groups according to their similar body weight, one group was divided into two groups, the other group was divided into two groups. Group 2 was randomly divided into two groups: group A (n = 6) and group B (n = 6) established a model via external jugular vein and group B (via femoral vein). After the establishment of the model, the differences between the two methods in operation time and X-ray exposure time were compared, and the general situation of experimental pigs was observed dynamically, before and immediately after operation, respectively. The changes of hemodynamics and cardiac structure were observed 1 month after operation and 3 months after operation by invasive pressure test and echocardiography. [results] one of 16 healthy pigs died of acute pericardium during operation. Three pigs were successfully treated with atrial septal puncture. Immediately after operation, the defect was confirmed by echocardiography and cardiac anatomy 3 months after operation. The other 12 pigs were successfully established by balloon dilatation via external jugular vein or femoral vein on the basis of successful atrial septal puncture with a balloon of 0.8 cm or 1.5 cm in diameter. The other 11 pigs survived except one died of infection after operation. The diameter of the defect was 1.16 卤0.15 cm ~ (-1) 卤0.14 cm ~ (-1) ~ 0.91 卤0.14 cm ~ (-1), respectively, and the diameter of the defect was 1.16 卤0.15 cm ~ (-1) and 0.91 卤0.14 cm ~ (-1) respectively. The external jugular approach was shorter than the femoral vein approach in operating time and X-ray exposure. Invasive pressure monitoring showed that there were significant differences in mean pulmonary artery pressure (MPAP), right ventricular pressure (RVP) and right atrial pressure (RAPP) between 3 months after operation (P < 0.01) and 3 months after operation (P < 0.01). The difference of right atrial diameter (RV), right ventricular diameter (RV) and left atrial diameter (LAA) was statistically significant (P < 0.01). Pathological examination 3 months after operation showed that scar tissue was formed, cardiac myocytes were arranged neatly, and no obvious degeneration was observed. Necrosis and proliferation of fibrous tissue, normal size of pulmonary arterioles, and no sign of muscularization. [conclusion]: transjugular interatrial septal puncture and balloon dilatation is an effective method for the establishment of porcine atrial septal defect (ASD) animal model. Simple, minimally invasive and repeatable method. The method of making porcine atrial septal defect animal model via external jugular vein was shorter in operation time and X-ray exposure time than that in femoral vein approach animal model of atrial septal defect. The animal model of porcine atrial septal deficiency mainly affects the hemodynamics and cardiac morphology of the right heart system. It is one of the methods to establish the left to right shunt pulmonary hypertension model.
【学位授予单位】：昆明医学院
【学位级别】：硕士
【学位授予年份】：2010
【分类号】：R-332

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