CAJ | 학술논문

目的：比较两种不同方法构建不停跳冠状动脉搭桥动物模型,探讨模型构建方法的可行性和优劣性。方法家犬20只随机分为头臂干组和降主动脉组,以小口径异种血管为桥血管。左侧第4肋间切口入胸,先行头臂干动脉或降主动脉端血管吻合,再行冠状动脉端血管吻合,术毕结扎左冠状动脉前降支近端。结果2组犬均无术中死亡。头臂干组和降主动脉组主动脉端血管吻合用时分别为(33.9±4.8) min和(29.6±3.5) min(P<0.05),冠状动脉端血管吻合用时分别为(28.5±3.0) min和(28.1±2.3) min(P>0.05),2组术中出血量分别为(77.5±16.2) mL和(66.5±12.3) mL(P>0.05)。降主动脉组术中侧壁钳夹降主动脉后股动脉血压明显降低,术后2只犬出现黑便。结论将小口径异种血管吻合在头臂干动脉或降主动脉均可成功构建犬不停跳冠状动脉搭桥模型；降主动脉组股动脉血压波动大,存在腹腔脏器缺血再灌注损伤；头臂干组血管吻合用时稍长,但术中股动脉血压波动小,模型构建相对更安全。
목적：비교량충불동방법구건불정도관상동맥탑교동물모형,탐토모형구건방법적가행성화우렬성。방법가견20지수궤분위두비간조화강주동맥조,이소구경이충혈관위교혈관。좌측제4륵간절구입흉,선행두비간동맥혹강주동맥단혈관문합,재행관상동맥단혈관문합,술필결찰좌관상동맥전강지근단。결과2조견균무술중사망。두비간조화강주동맥조주동맥단혈관문합용시분별위(33.9±4.8) min화(29.6±3.5) min(P<0.05),관상동맥단혈관문합용시분별위(28.5±3.0) min화(28.1±2.3) min(P>0.05),2조술중출혈량분별위(77.5±16.2) mL화(66.5±12.3) mL(P>0.05)。강주동맥조술중측벽겸협강주동맥후고동맥혈압명현강저,술후2지견출현흑편。결론장소구경이충혈관문합재두비간동맥혹강주동맥균가성공구건견불정도관상동맥탑교모형；강주동맥조고동맥혈압파동대,존재복강장기결혈재관주손상；두비간조혈관문합용시초장,단술중고동맥혈압파동소,모형구건상대경안전。
Objective To study the feasibility of model building methods by analyzing the advantages and disadvantages between the two different methods to build off-pump coronary artery bypass graft animal model. Methods Twenty dogs were randomly divided into two groups:brachiocephalic artery group and descending aorta group. Small-caliber heterogeneous vascular vessels were used as bridge vessels. The incision was in the fourth intercostal space of the left chest. Vascular anastomosis was firstly done between the brachiocephalic artery and bridge vessels,or between descending aorta and bridge vessels,prior to coronary vascular and bridge vessels anastomosis. Results The dogs of two groups were not dead during operation. Brachiocephalic artery group and the descending aorta group:aortic vascular anastomosis times were (33.9 ±4.8) min and (29.6 ±3.5) min respectively (P<0.05),coronary vascular anastomosis time were (28.5 ±3.0) min and (28. 1 ± 2. 3) min respectively (P>0. 05). The surgical blood losses of the two groups were (77. 5 ± 16. 2) mL and (66. 5 ± 12. 3) mL re-spectively (P>0. 05). After side clamping descending aorta,femoral blood pressure significantly decreased in descending aorta group,and the two dogs had melena after operation. Conclusion Off-pump coronary artery bypass graft models were both constructed successfully by the two ways. Descending aorta group of femoral artery blood pressure violently fluctuated and had abdominal organs’ ischemia reperfusion in-jury. Though brachiocephalic artery group anastomosis group spent a little longer time,they had stable artery blood pressure during operation. As a result,the way of constructing animal model of brachiocephalic artery group is safer.