家犬肝动脉热化疗的实验研究

Experimental research on thermochemotherapy of domestic dog through heptatic artery

目的 观察家犬肝动脉灌注热化疗过程中的升温情况 ,心肺肾的耐受能力 ,以及术后肝脏的生化、组织学改变。方法 使用自行设计的水浴式加温箱和输液泵。家犬 10条 ,分为A、B两组 ,各 5条 ,经肝动脉置管灌注化疗。A组灌注 5 %葡萄糖液 (GS) ,液温 43°C ,时间 30min ,流量 30ml/min ;B组灌注热化疗液温 45°C ,时间 30min ,流量 40ml/min ,于 5 %GS液中加入丝裂霉素 (MMC)按 0 .2mg/kg3条 ,加入顺铂 (CDDP)按 1mg/kg 2条。 结果 动物肛门温度比术前升高 0 .3～ 0 .5°C ,肝脏温度升高 0 .5～ 1.0°C ,术中心率、呼吸与术前变化不大。灌注 15min时造影 4条 ,肝动脉均有不同程度扩张 ,灌流增加现象 ,灌注 30min时造影 6条 ,5条肝动脉有收缩及灌流减少现象 ,另 1条变化不大。术后转氨酶轻、中度升高 ,1周内基本恢复。病理学上心肺肾没有出现急性反应 ,肝组织的损害轻微而可逆。结论 液温 43°C和 45°C ,时间 30min经肝动脉热化疗方案可为健康家犬所接受 ,这为肝动脉热化疗治疗肝癌提供依据。

Objective The research is to study the temperature rising situation in the thermochemotherapy process of the domestic dog through the hepatic artery, and the bearing ability of heart, liver, and kidney during the process, as well as the biochemical and histological change of the liver after the procedure. Methods A thermostated container of water bath and an infusion pump, both designed domestically, were adopted. Ten domestic dogs were divided into 2 groups of A and B with 5 dogs respectively. Through hepatic artery infusion for group A, glucose solution (GS) was administered at 43°C for 30 minutes, with the flowing rate of 30ml/min, in group B 5% GS at 45°C for 30 minutes, with the flowing rate of 40ml/min added with chemotherapy drug MMC(0.2mg/kg) was administered to 3 dogs and 5% GS with the same flowing rate added with CDDP(1mg/kg) into other 2 dogs. Results The temperature of anus and liver was 0.3～0.5°C and 0.5～1.0°C higher than before the procedure respectively, there was no significant rate changes of heart and respiration during and before the procedure. Four dogs were radiographied after 15 minutes' infusion, showing different degrees of hepatic artery dilation accompanied with relevant increase of infusion. Six dogs were radiographied after 30 minutes' infusion, 5 of them showed arterial contraction astescal on accompanied with relevant decrease of infusion. There appeared slight or moderate increase of aminopherase after the procedure, but in actually returned to normal within a week. Pathologically, there appeared no acute effect on heart, lung and kidney other than slight and reversible damage to hepatic tissue. Conclusions Healthy dogs can endure the chemotherapy treatment of infusion through hepatic arterial fistula at 43°C 45°C for 30 minutes.