自制可调节肺动脉环缩装置对右心室作用实验研究

Experimental study of the effect on right ventricle with an adjustable pulmonary artery banding device

目的通过对动物右心室作用实验的研究,验证自制可调节肺动脉环缩装置的有效性。方法 12只健康雄性小尾寒羊,5～6个月龄,体质量26～37kg。随机分为实验组和对照组,每组各6只,体质量分别为(29.00±2.78)kg和(28.36±4.24)kg,差异无统计学意义(P=0.722),从左侧第二肋间进胸,游离肺动脉主干,置入自制可调节肺动脉环缩装置,向球囊内注入0.9%NaCl溶液,逐渐增加右心室压力,进行心室训练,达到训练标准所需时间为9～18d。观察超声下右心室形态、血流动力学及心肌组织病理学变化。结果超声下右心室形态、室间隔位置、游离壁厚度均较训练前发生明显改变;血流动力学结果表明右心室/左心室收缩压力比值大于0.6,达到临床上心室训练的标准;右心室的收缩功能(P<0.05)和舒张功能(P<0.001)均得到了增强;病理检查结果右心室游离壁厚度及质量、右心室肥大指数、心肌细胞横径与对照组比较差异存在显著统计学意义(P<0.001)。结论该装置能够达到肺动脉环缩、训练心室的目的 ,并且可双向调节,使用方便,效果可靠。

Objective To evaluate the effectiveness of a self-made new adjustable pulmonary artery banding device.Methods A total all of 12 male sheep, 5～6 months old, 26～37 kg , were randomly divided into experimental and control group, 6 animals in each group,（29.00 ± 2.78） kg, and（28.36 ± 4.24） kg, no statistically significant difference.After opening chest through the second left intercostal, pulmonary trunk was dissociated and the adjustable pulmonary artery banding device was put around it.Then balloon of device was gradually inflated to narrow pulmonary artery and to train right ventricle.The shape of right ventricle was studied by echocardiogram and changes of hemodynamic and myocardial histopathology were observed.Results Observed by echocardiogram, the shape and thickness of right ventricle and position of septum were different from that before training.Hemodynamic results showed that the ratio of right ventricular contraction pressure to the left had achieved the goal of clinical practice（greater than 0.6）.Both of systolic function（P 0.05） and diastolic function（P 0.001） were enhanced.The thickness and quality of right ventricle, right ventricular hypertrophy index and cardiac myocyte diameter were significantly different from that of the control group in pathological examination（P 0.001）.Conclusion This device is able to achieve the aim of pulmonary artery banding and ventricular training.Furthermore, it may implement the dual-adjustment, easily and efficiently.