一种新型全腔静脉肺动脉吻合术动物模型的建立

Establishment of a novel total cavopulmonary connection experimental model

目的 建立一种与临床术式相近的全腔静脉肺动脉吻合术实验动物模型。方法 选用成年杂交犬 1 0条。根据下腔静脉吻合口的位置不同分为两组 :1组为下腔静脉与右肺动脉吻合 ;2组为下腔静脉与主肺动脉吻合。两组动物模型中上腔静脉全部与右肺动脉吻合。全腔静脉肺动脉吻合术模型在非体外循环下通过心外管道建立。结果 两组动物术后 3 0min、1h及 2h血液循环指标稳定 ,两组犬血流动力学指标差异无显著性 (P >0 .0 5)。上腔静脉压维持在 1 2mmHg(1mmHg =0 .1 3 3kPa)以上时才能维持正常的血液循环。全腔静脉肺动脉吻合术后 ,肺血管阻力随静脉压的升高而下降。所有动物在手术结束后都能进行 2h以上的实验数据监测和观察。结论 犬心外管道全腔静脉肺动脉吻合术动物模型与临床实际术式相接近 ,是一种可靠的急性动物实验模型 ;全腔静脉肺动脉吻合术后 ,静脉压维持到合适水平是维护循环稳定的重要特征。

Objective To establish an experimental total cavopulmonary connection (TCPC) model in dogs which is closed to clinical operation.Methods Ten adult mongrel dogs were divided into two groups according to the anastomosis site of inferior vena cave (IVC): group I, IVC anastomosed to right pulmonary artery; groupⅡ: IVC anastomosed to main pulmonary artery. Superior vena cave (SVC) was anastomosed to right pulmonary artery in the two groups. The experimental model using extracardiac conduit was developed without bypass.Results The blood circulation in this model was stable within 2?h and was able to sufficiently sustain with the pressure of SVC above the 12?mm?Hg(1?mm?Hg=0.133?kPa).The pulmonary vascular resistant got lower while superior vena cave pressure (SVCP) was increased.Conclusion The experimental dog model of TCPC is closed to clinical operation procedure and is a reliable, acute animal model. The sustained high level of SVCP is the most important factor in the early post operative period of TCPC.