中华外科杂志
中華外科雜誌
중화외과잡지
CHINESE JOURNAL OF SURGERY
2008年
15期
1163-1165
,共3页
朱成楚%叶敏华%马德华%陈仕林%林仙方%唐礼江%甘梅富%朱广球%包卫光%周文娟%叶中瑞
硃成楚%葉敏華%馬德華%陳仕林%林仙方%唐禮江%甘梅富%硃廣毬%包衛光%週文娟%葉中瑞
주성초%협민화%마덕화%진사림%림선방%당례강%감매부%주엄구%포위광%주문연%협중서
胸腔镜%模型%动物%心肌缺血
胸腔鏡%模型%動物%心肌缺血
흉강경%모형%동물%심기결혈
Thoracoscopes%Model%animal%Myocardial ischernia
目的 探讨应用胸腔镜技术建立小型猪慢性心肌缺血模型的效果及可行性.方法 23只中国实验小型猪,雄性,体重20～30 kg,平均(29.3±4.3)kg,年龄8～11个月,平均(9.3±1.8)个月.在完全胸腔镜下将Ameroid环置于回旋支主干,术前及术后6周分别进行冠状动脉造影及超声心动图检查.结果 23只猪中20只顺利完成手术,手术时间25～125 min,平均(46±9)min.术中出血量30～60 ml,平均(55±12)ml.术后6周内因肺部感染、二次造影时心律失常及麻醉意外死亡3只.术后6周行冠状动脉造影显示,7只动物回旋支完全闭塞,13只狭窄大于85%.超声心动图心肌收缩及舒张功能明显下降,术前射血分数(65.0±6.3)%,短轴缩短率(36.2±4.3)%;术后6周射血分数(41.0±9.3)%,短轴缩短率(34.2±2.3)%,均低于术前水平(P<0.05).结论 应用胸腔镜技术放置Ameroid环可以有效建立小型猪慢性心肌缺血模型.
目的 探討應用胸腔鏡技術建立小型豬慢性心肌缺血模型的效果及可行性.方法 23隻中國實驗小型豬,雄性,體重20～30 kg,平均(29.3±4.3)kg,年齡8～11箇月,平均(9.3±1.8)箇月.在完全胸腔鏡下將Ameroid環置于迴鏇支主榦,術前及術後6週分彆進行冠狀動脈造影及超聲心動圖檢查.結果 23隻豬中20隻順利完成手術,手術時間25～125 min,平均(46±9)min.術中齣血量30～60 ml,平均(55±12)ml.術後6週內因肺部感染、二次造影時心律失常及痳醉意外死亡3隻.術後6週行冠狀動脈造影顯示,7隻動物迴鏇支完全閉塞,13隻狹窄大于85%.超聲心動圖心肌收縮及舒張功能明顯下降,術前射血分數(65.0±6.3)%,短軸縮短率(36.2±4.3)%;術後6週射血分數(41.0±9.3)%,短軸縮短率(34.2±2.3)%,均低于術前水平(P<0.05).結論 應用胸腔鏡技術放置Ameroid環可以有效建立小型豬慢性心肌缺血模型.
목적 탐토응용흉강경기술건립소형저만성심기결혈모형적효과급가행성.방법 23지중국실험소형저,웅성,체중20～30 kg,평균(29.3±4.3)kg,년령8～11개월,평균(9.3±1.8)개월.재완전흉강경하장Ameroid배치우회선지주간,술전급술후6주분별진행관상동맥조영급초성심동도검사.결과 23지저중20지순리완성수술,수술시간25～125 min,평균(46±9)min.술중출혈량30～60 ml,평균(55±12)ml.술후6주내인폐부감염、이차조영시심률실상급마취의외사망3지.술후6주행관상동맥조영현시,7지동물회선지완전폐새,13지협착대우85%.초성심동도심기수축급서장공능명현하강,술전사혈분수(65.0±6.3)%,단축축단솔(36.2±4.3)%;술후6주사혈분수(41.0±9.3)%,단축축단솔(34.2±2.3)%,균저우술전수평(P<0.05).결론 응용흉강경기술방치Ameroid배가이유효건립소형저만성심기결혈모형.
Objective To create a standard mini-swine model of chronic ischemic myocardium by endoscopy for the research of gene transfer and stem cell. Methods Twenty-three male China experimental mini-swines were used, aged from 8 to 11 months with a mean of (9.3±1.8) months and weighed from 20 to 30 kg with a mean of (29.3±4.3) kg, The myocardial ischemia was established by gradual occlusion of the left circumflex coronary artery (LCX) with an Ameroid constrictor. The Ameroid constrictor was implanted around LCX by endoscopy. Selective coronary angiography, electrocardiogram and Echo-Doppler study were performed perioperatively to evaluate the degree of stenosis. Results Chronic ischemic myocardial models were successfully generated in 20 of 23 swine by full-endoscopy. Ameroid constrictors were placed at the LCX accurately. Three swine died of anesthetic accident, cardiac arrhythmia at secondary coronary angiography, and pulmonary infection within 6 weeks after operation respectively. Operation time was 25 to 65 rain with a mean of (46±9) min. The blood loss was 30 to 60 ml with a mean of (55±12) ml. Six weeks later, coronary angiography revealed the total occlusion and partial stenosis (> 85% ) of the LCX occurred in 7 and 13 swine respectively. Cardiac systolic and diastolic dysfunction were found in all swine. The ejection fraction value was (65.0±6.3)% before operation and (41.0 +9.3)% after operation (P=0.008 ). The fractional shortening value was (36.2±4.3) % before operation and (34.2±2.3) % after operation (P=0.027). Conclusion The endoscopic surgery is a less invasive way to create a standard mini-swine model of chronic ischemic myocardium with effective results.
