引导式实验动物血管插管装置在家兔肝动脉插管术中的应用

Application of guided - catheterization device for hepatic artery catheterization in rabbits

目的探讨直视下新型引导式实验动物插管装置及改良术在家兔肝动脉插管术中应用的可行性。方法将45只白家兔随机均分为3组,组Ⅰ在剖腹直视下用常规插管装置经肝总动脉按常规法行肝动脉插管术,组Ⅱ在DSA监视下经股动脉按Seldinger穿刺法行肝动脉插管术,组Ⅲ在剖腹直视下用新型引导式插管装置经胃十二指肠动脉采取改良术式逆行肝动脉插管术。对3组家兔肝动脉插管的成功率、插管时间及术后效果进行比较和评价。结果组Ⅰ、Ⅱ、Ⅲ家兔肝动脉插管术的成功率分别为60.0%、73.3%、86.7%,组Ⅲ与组Ⅰ相比差异有统计学意义(P<0.05);所用时间分别为(42.0±0.5)、(31.4±0.8)、(25.2±0.6)min,组Ⅲ与组Ⅰ和组Ⅱ相比差异具有统计学意义(P<0.01,P<0.05);术后不良反应及并发症的发生率分别为46.7%、33.3%、20.0%,组Ⅲ与组Ⅰ和组Ⅱ相比差异具有统计学意义(P<0.01,P<0.05)。结论在剖腹直视下,用新型引导式插管装置经胃十二指肠动脉行改良术式逆行肝动脉插管术提高了实验家兔肝动脉插管的质量和效率,具有安全、简便等优点,对临床具有一定参考价值。

Objective To explore the feasibility of using new guided-catheterization and modified technique for hepatic artery catheterization in rabbits under direct vision.Methods A total of 45 rabbits were evenly randomized into 3 groups.In group Ⅰ the catheterizations of hepatic artery were performed by conventional technique under direct vision;in group Ⅱ the catheterizations were performed with Seldinger technique under DSA;and in group Ⅲ the catheterizations were performed by the new guided-catheterization and modified retrograde technique under direct vision.Then the success rate,catheterization time and survival rate were compared after catheterization among the three groups.Results The success rates of catheterization were 60.0%,73.3% and 86.7% in group Ⅰ,Ⅱ,and Ⅲ,respectively,with significant difference found between group Ⅲ andⅠ（P〈0.05）.The periods of catheterization were（42.0 ±0.5） min,（31.4 ±0.8） min,and（25.2 ±0.6） min,respectively,with the periods in group Ⅲ being significantly shorter than those in groupⅡ and Ⅰ（P〈0.05,P〈0.01）.The incidence rates of the adverse reactions and complications were 46.7%,33.3% and 20.0%,respectively,with that in group Ⅲ being significantly less than those in groupⅡ and Ⅰ（P〈0.05,P〈0.01）.Conclusion The new guided-catheterization device and improved technique using transgastroduodenal artery not only can improve the quality and efficiency of hepatic artery catheterization in rabbits,but also is safe and easy-to-perform.