CAJ | 학술논문

目的：应用流体模型法制备一种适用于评价急性缺血性脑卒中机械取栓装置的新血栓模型，并评价其特性。方法采用动态血栓形成系统制备流体模型血栓，同时采用传统静止法制备血栓。通过手动拉伸试验（各15个血栓样本）和导管注射试验（各15个血栓样本）来进行血栓机械性能的检测。将上述2种模型血栓（各5个）及5例卒中患者的血栓标本进行HE染色，并对3种血栓的病理结果进行比较。选取2只猪，以流体模型血栓建立急性猪血管栓塞模型，评估其显影性。2种血栓最大拉伸长度的比较采用独立样本t检验，导管注射实验后血栓断裂率通过Fisher精确检验进行比较。结果2种模型血栓的最大拉伸长度分别为（4.28±0.23）和（3.16±0.13） cm，差异有统计学意义（t＝16.38，P＜0.01）；经导管注射实验后的断裂率分别为13％（2/15）和60％（9/15），静止法制备的血栓的断裂率高于流体模型制备的血栓，差异同样具有统计学意义（ P＜0.05）。流体模型制备的血栓显示出同卒中患者的血栓标本类似的混合性血栓结构，而静止模型血栓镜下仅见大量红细胞分布；2只猪的舌动脉、颈浅动脉共8根血管均成功实现栓塞，且显影良好。结论流体模型制备的血栓机械性能稳定、显影性好，且同卒中患者的在体血栓具有类似的组织学结构。
목적：응용류체모형법제비일충괄용우평개급성결혈성뇌졸중궤계취전장치적신혈전모형，병평개기특성。방법채용동태혈전형성계통제비류체모형혈전，동시채용전통정지법제비혈전。통과수동랍신시험（각15개혈전양본）화도관주사시험（각15개혈전양본）래진행혈전궤계성능적검측。장상술2충모형혈전（각5개）급5례졸중환자적혈전표본진행HE염색，병대3충혈전적병리결과진행비교。선취2지저，이류체모형혈전건립급성저혈관전새모형，평고기현영성。2충혈전최대랍신장도적비교채용독립양본t검험，도관주사실험후혈전단렬솔통과Fisher정학검험진행비교。결과2충모형혈전적최대랍신장도분별위（4.28±0.23）화（3.16±0.13） cm，차이유통계학의의（t＝16.38，P＜0.01）；경도관주사실험후적단렬솔분별위13％（2/15）화60％（9/15），정지법제비적혈전적단렬솔고우류체모형제비적혈전，차이동양구유통계학의의（ P＜0.05）。류체모형제비적혈전현시출동졸중환자적혈전표본유사적혼합성혈전결구，이정지모형혈전경하부견대량홍세포분포；2지저적설동맥、경천동맥공8근혈관균성공실현전새，차현영량호。결론류체모형제비적혈전궤계성능은정、현영성호，차동졸중환자적재체혈전구유유사적조직학결구。
Objective To prepare a new thrombus model by fluid model method , which is suitable for evaluation of mechanical thrombectomy devices for acute stroke.Methods The fluid model adopted the Chandler loop theory , while the static model adopted conventional method.Mechanical properties of thrombi prepared by fluid model and static model were measured by manual elongation test ( 15 samples in each group) and catheter injection test (15 samples in each group ).Histological structure was compared among the above thrombus models ( 5 samples in each group ) and specimens of five patients with stroke by hematoxylin-eosin staining method.Then, thrombi in fluid model were utilized to establish embolization of vessels in swine model ( two pigs ) for evaluation of radiopacity.Independent-Sample test was performed to compare the maximum tensile length of two methods , and Fisher′s exact test was used to compare the rate of thrombus fragmentation after catheter injection test.Results The maximum tensile length of two models were (4.28 ±0.23) and (3.16 ±0.13) cm, respectively, and the difference was statistically significant (t=16.38, P<0.01);After catheter injection, the fracture rates of thrombus were 13% (2/15) and 60%(9/15), which were also statistically significant (P<0.05).As to histological structure, thrombi prepared by fluid model showed mixed thrombus structure , which similar to thrombi of stroke patients , But thrombi prepared by static model were replete with erythrocytes under the microscope .A total of eight vessels ( lingual arteries and superficial cervical arteries ) in two swines were successfully occlusive ( TIMI 0 or 1 ) , and sufficient radiopacity of each injected thrombus was observed.Conclusions The thrombi prepared by fluid model not only have good mechanical stability and sufficient radiopacity , but their histological structure is similar to thromboemboli retrieved from cerebral arteries of patients with acute stroke.