CAJ | 학술논문

目的探讨经颈动脉途径大鼠肝动脉插管及介入治疗的可行性及安全性.方法 30只SD大鼠随机平均分成2组,均于腹腔麻醉下暴露左颈总动脉,穿刺置入穿刺针外鞘,经鞘引入微导管至腹腔动脉造影了解其解剖结构后超选至肝固有动脉开口附近,1组灌注5 mg表阿霉素,另1组用碘化油及聚乙烯醇(PVA)进行栓塞,灌注或栓塞后均行腹腔动脉造影复查血管的通畅情况.术后观察实验鼠的2周生存率(SR)及相关并发症的情况.结果 30只大鼠除1只插管失败外均成功插管并完成腹腔动脉及胃十二指肠动脉造影,成功率96.7％ (29/30).28例(28/29,96.6％)显示胃十二指肠动脉(GDA)与肠系膜上动脉(SMA)之间的吻合支.14例行灌注治疗的实验鼠造影复查时腹腔动脉诸分支均未发生闭塞；15例行栓塞治疗的在栓塞后行腹腔动脉造影示10例( 10/15,66.7％)出现胃十二指肠动脉主干闭塞,其余5例(5/15,33.3％)仍保持通畅.术后所有大鼠肢体活动未出现异常,5例大鼠于术后12～24 h出现左侧上眼睑下垂,1周后均消失；10例胃十二指肠动脉主干栓塞的大鼠术后3d内进食情况较其余大鼠差,3d后逐步恢复正常.实验鼠术后2周时存活27例,生存率为93.1％ (27/29),1例死于切口感染,1例死于颈部血肿.结论经颈动脉途径大鼠肝动脉插管及介入治疗是安全可行的,有较高的应用价值.
목적 탐토경경동맥도경대서간동맥삽관급개입치료적가행성급안전성.방법 30지SD대서수궤평균분성2조,균우복강마취하폭로좌경총동맥,천자치입천자침외초,경초인입미도관지복강동맥조영료해기해부결구후초선지간고유동맥개구부근,1조관주5 mg표아매소,령1조용전화유급취을희순(PVA)진행전새,관주혹전새후균행복강동맥조영복사혈관적통창정황.술후관찰실험서적2주생존솔(SR)급상관병발증적정황.결과 30지대서제1지삽관실패외균성공삽관병완성복강동맥급위십이지장동맥조영,성공솔96.7％ (29/30).28례(28/29,96.6％)현시위십이지장동맥(GDA)여장계막상동맥(SMA)지간적문합지.14례행관주치료적실험서조영복사시복강동맥제분지균미발생폐새；15례행전새치료적재전새후행복강동맥조영시10례( 10/15,66.7％)출현위십이지장동맥주간폐새,기여5례(5/15,33.3％)잉보지통창.술후소유대서지체활동미출현이상,5례대서우술후12～24 h출현좌측상안검하수,1주후균소실；10례위십이지장동맥주간전새적대서술후3d내진식정황교기여대서차,3d후축보회복정상.실험서술후2주시존활27례,생존솔위93.1％ (27/29),1례사우절구감염,1례사우경부혈종.결론 경경동맥도경대서간동맥삽관급개입치료시안전가행적,유교고적응용개치.
Objective To invcstigatc the feasibility and safety of catheterization in rat hepatic artery and interventional therapy through carotid artery.Methods A total of 30 Sprague-Dawley rats were randomly divided into 2 groups.All were punctured through left common carotid artcry (LCCA) under intraperitoneal injection anesthesia.Microcatheter was inserted through a puncturing outer cannula into celiac artery and angiography performed to investigated the anatomical structure.Then a microcathctcr was insertcd into proper hepatic artery.One group was perfused with epirubicin 5 mg while another embolized with lipidol and polyvinyl (PVA).The status of vascular patency was re-examined by celiac angiography after perfusion and embolization.The 2-week survival rate (SR) and related complications were observed.Results Except for one failed case,all other cases were successfully inserted and celiogastroduodenal arteriography was completed with a success rate of 97％ (29/30).The anastomosis between gastroduodenal artery (GDA) and superior mesenteric artery (SMA) was demonstrated in 28 cases (28/29,96.6％).In 14 cases with perfusion therapy,artcriography demonstrated all branches of celiac artery had no occlusion while 10 embolized cases ( 10/15,67％ ) had the main branch occlusion of gastroduodenal artery and 5 (5/15,33％ ) stayed open.No postoperative abnormality was found in thc limb motor function.Fivc had the drooping of left upper eyelid during 12 -24 h after intervention and subsided after a week.And 10 embolized via main branch of gastroduodenal artery showed a poor appetite within 3 days postoperation and recovered gradually after 3 days.After intervention,27 rats survived in 2 weeks.The survival rate was 93％ (27/29).One died of incision infection and another neck hematoma.Conclusion Catheterization in hepatic artery and interventional therapy through carotid artery is both feasible and safe.It may have a high application value.