微创介入方舱内实施犬金属异物取出术实验研究

Study on Metallic Removal of Foreign Body Performed in Mobile Medical Cabin in Dogs under Wartime Comprehensive Treatments

目的探讨在野战条件下于综合手术救治方舱内利用C型臂X线机实施金属异物取出术的可行性。方法取6只健康成年犬,随机分为A、B组,每组3只。麻醉后将大小为9 mm×19 mm的金属弹头分别置入家犬腹腔内及腹壁肌肉中,两组家犬均拍摄异物所在位置正、侧位X线片,A组以大头针标记其位置,B组用记号笔标记其位置,之后给予搬运25 m。A组利用综合手术救治方舱中C型臂X线机进行术中探查,取出金属异物;B组参照术前腹部正、侧位平片施行金属异物取出术。每只家犬重复操作3次。记录A组搬运25 m后体内金属弹头位移距离、两组实施金属异物取出术时间,术后复查X线片,观察金属异物取出情况。结果 A组腹腔内金属弹头位移距离大于腹壁肌肉内的金属弹头位移距离,金属弹头取出手术时间短于B组(P<0.01);两组腹壁肌肉内金属弹头取出手术时间比较差异无统计学意义(P>0.05)。术后复查X线片显示家犬体内金属弹头均完整取出。结论野战条件下,于综合手术方舱内在C型臂X线下实施腹腔内金属异物取出术定位准确,用时少,效果满意。

Objective To explore the feasibility of metallic removal of foreign body performed with mobile C-arm x-ray machine in a comprehensive operation cabin in wartime. Methods Six healthy adult dogs were randomly divided into group A and B （n = 3 ）. After anesthesia, 9 mm x 19 mm metal bullets were respectively inserted within the abdominal cavity and abdominal wall muscles of each dog. All the dogs had entopic and lateral position X-ray pictures of foreign body places taken, and group A was marked for positions with pins, and group B was marked with maker pens. All the dogs were transported 25 m. Dogs in group A were taken out of foreign bodies with mobile C-arm X-ray machine in a comprehensive operation cabin, while dogs in group B performed removal of foreign bodies according to preoperative X-ray pictures. Each dog was repeatly modelled for 3 times. The shifting distances of metal bullets in group A after being carried 25 m, the operation time and postoperative results of X-ray picture of the two groups were recorded, and removing conditions of metallic foreign bodies were also observed. Results In group A, the shifting distance of bullet within the abdominal cavity was longer than that in abdominal wall muscles, while operation time in group A was shorter than that in group B （P 〈 0.01）; there was no significant difference in operation time of abdominal wall muscles between the two groups （P 〉 0.05）. The postoperative X-ray examination showed that all the metal bullets were removed from the bodies of the dogs in whole. Conclusion Metallic removal of foreign body performed with mobile C-arm X-ray machine in a comprehensive operation cabin under wartime is accurate, fast and effective.