一种新型建立胃食管反流病的动物模型的方法:导尿管球囊扩张术

The method of establishing a new animal model of gastroesophageal reflux disease: balloon dilatation catheter

目的建立一种安全有效、操作简便而又符合正常生理解剖的反流性食管炎动物模型。方法 20只新西兰大白兔分为二组,A组为导尿管球囊扩张术组,共12只,B组为假手术对照组,共8只。A组采用经口插入10Fr双腔导尿管,开腹定位食管下括约肌后,利用导尿管球囊扩张食管下括约肌,以制作反流性食管炎的动物模型,B组开腹暴露胃食管连接部,关腹。所有实验动物于术后10 d行2 h下段食管pH值监测,术后4周处死实验动物,取食管下段组织标本,行HE染色,观察标本食管炎发生率。结果二组大白兔术后存活率无明显差异(A组:91.7%vs B组:100.0%,P=1.000),二组术后食管下端p H值监测:p H<4的时间百分比、反流次数以及p H<4持续时间超过5 min次数比较,差异有统计学意义(t=3.98、4.91、4.99,P=0.001、<0.001、<0.001)。A组造模成功率为75.0%,排除手术死亡大白兔后,造模成功率为81.8%。结论 Forley导尿管球囊扩张法可有效建立反流性食管炎动物模型,该方法建立的模型符合正常的生理解剖结构,保留了完整的胃食管连接部抗反流的解剖结构,适用于外科手术治疗的研究。

Objective To explore an effective,safe and convenient method to stablish a reflux esophagitis model.Methods Twenty New Zealand rabbits were divided into 2 groups.Twelve rabbits which underwent catheter balloon dilatation were allocated into A group while 8 rabbits which underwent sham operation were allocated into B group.In A group,rabbits were intubated with a 10Fr double lumen catheter.Lower esophageal sphincter was confirmed after opening abdominal cavity.In B group,laparotomy was performed.Then abdominal cavity was closed after lower esophageal sphincter was confirmed.All rabbits received 2-hour pH monitoring on postoperative day 10 and was sacrificed in postoperative week 4.Esophageal tissues were taken out and stained with HE.The rate of esophagitis was evaluated.Results Survival was not significantly statistical different between 2 groups （A group：91.7% vs B group：100%, P =1.000）.The data of 2-hour pH monitoring including total time of pH 〈4 （%）in 24-hours,number of reflux episodes and number of reflux episodes 〉5 min showed significantly statistical difference between 2 groups （t =3.98,4.91,4.99;P =0.001,〈0.001,〈0.001）.The success rate of reflux esophagitis model establishment was 75% in A group.Excluding dead rabbits,success rate of reflux esophagitis model establishment was 81.8%.Conclusion Forley catheter balloon dilatation is an effective way to establish esophageal reflux model.This method which reserves intact antireflux barrier of gastroesophageal junction does not change normal physiologic anatomy.This method is suitable for the investigation of surgical therapy for reflux esophagitis.