应用Forley导尿管建立兔反流性食管炎模型

Balloon dilatation of Forley catheter in establishing a reflux esophagitis model

目的探讨一种更安全有效且符合生理解剖的反流性食管炎动物模型的建立方法。方法健康5个月龄新西兰大白兔45只,随机均分为3组:贲门括约肌切开术组(A组),贲门括约肌部分切除术组(B组),Forley导尿管气囊扩张术组(C组)。建模前行食管造瘘术,3组兔分别采用各自方法建立反流性食管炎模型,术前及术后2周进行24hpH值监测,术后4周处死动物,观察大体标本及镜下标本。结果 B组死亡率较其余两组高(P=0.057)。B组兔24h内pH<4的时间百分比、反流次数及pH<4持续时间超过5min的反流次数均高于其余两组,C组略高于A组,但差异无统计学意义;三组造模成功率几近相同。造模成功的兔中,B组中重度反流性食管炎比例较高,但差异无统计学意义。结论贲门括约肌部分切除术造模效果较为理想,但死亡率高;气囊扩张术术式简单,安全性高,造模效果理想,且符合正常生理解剖结构,适合内镜治疗及其他新型治疗方法的基础研究。

Objective To explore a safe and effective way to establish reflux esophagitis model consistent with the anatomical structure.Methods Forty-five New Zealand rabbits aged 5 months were randomly divided into three groups.The rabbits undergoing lower esophageal sphincter incision were assigned to A group,those undergoing partial cardiomyectomy to B group,and those undergoing balloon dilatation by Forley catheter to C group.All the rabbits underwent esophageal fistulation before establishment of reflux esophagitis model.24hour-pH monitoring was performed to all the rabbits before and at 2weeks postoperatively.At 4 weeks postoperatively,the animals were sacrificed for histological and electron microscopic results.Results The mortality rate in B group was higher than those of the other 2groups（P=0.057）.With respect to the total time ratio of pH〈4（%）in 24 hours,number of reflux episodes and number of reflux episodes〉5min,a clear trend was seen as B group 〉C group 〉A group;however,there were no significant differences among the 3groups.The success rates of establishing reflux esophagitis model were similar among the 3groups.For the reflux esophagitis models,moderate/severe esophagitis was more commonly-seen in B group than in the other 2groups,but showing no significant difference.Conclusion Partial cardiomyectomy is a more effective way to establish a reflux esophagitis model,but with higher mortality.Balloon dilatation is a safe and effective to establish a reflux esophagitis model,which is also more consistent with anatomical structure and suitable for research of endoscopic or other new surgeries.