机械分流泵防治门脉高压食管静脉曲张破裂出血的动物实验研究

Machine-shunt Pump for Esophageal Variceal Hemorrhea in Portal Hypertension Model of Big Animal

目的通过实验犬门脉高压模型验证机械泵门体分流对防治门脉高压食管静脉曲张破裂出血的有效性和安全性。方法 24条实验成年犬行腹部手术采用门脉主干捆绑气囊导管引出体外注水的方式制成门脉高压动物模型,同时行门脉插管,出现食管静脉曲张破裂出血后随机分为机械泵持续门体分流A组和保守治疗B组治疗时间1周,分别对门脉压改变、止血率、血液主要有形成份及病死率进行检测记录。结果 24条模型犬均出现门脉高压食管静脉曲张破裂出血,A、B两组发生出血的时间和门脉压升高程度以及血红蛋白降低程度无明显差异。治疗后A组门脉压降低程度、止血率明显高于B组。病死率则明显低于B组(P<0.01)。A组使用机械分流泵未见血液成份明显机械损伤。结论使用机械分流泵在大型动物中行门体分流可以快速、可控降低门静脉压,从而即时、高效、确切中止门脉压食管静脉破裂出血。中长时段的机械分流对血液成份无明显损伤。

Objective To evaluate the efficacy and safety of machine-shunt pump for esophageal variceal hemorrhea in portal hypertension model of big animals. Methods 24 mature dogs were made portal hypertension model by portal trunk-stricture operation and randomized into two groups. Group A was treated with machine-shunt pump, and group B with medicine, to determine the changes of portal pressure, hemostatic rate, morality and blood cells. Results Esophageal variceal hemorrhea occurred in all 24 dogs, without significant difference in increment of portal pressure and decrement of hemoglobin between two groups. After theatment, significant difference had in decrement of portal pressure hemostatic rate, mortality between the two groups, without machine injury of blood cells in group A. Conclusions Machine-shunt pump can get immediate and controllable decrement of portal pressure in treatment of esophageal variceal hemorrhea in portal hypertension model of big animals. It is an effective and safe way for esophageal variceal hemorrhea of portal hypertension.