动脉内高压注射法制备创伤性颅底动脉损伤动物模型

High-pressure intraarterial injection for establishing animal model of traumatic skull base artery injury

目的利用动脉内高压注射法制备创伤性颅底动脉损伤（TSBAI）动物模型并探讨其价值。方法新西兰兔50只，按随机数字表法分为颈动脉内高压注射组（实验组，20只）、颈动脉内无张力注射组（假手术组，20只）和单纯显露颈动脉组（对照组，10只），观察模型动物存活情况，用CT血管造影（CTA）测量颈动脉直径，并在显微镜下观察受累颈动脉病理结构改变情况。结果实验组死亡3只，其余17只存活良好，模型动物制备成功率为85％。假手术组死亡2只，其余18只存活。对照组10只全部存活。术后1周，实验组右侧颈总动脉直径为（1．62±0．10）mm，假手术组为（2．25±0．08）mm，对照组为（2．43±0．15）mm，实验组颈动脉直径与假手术组及对照组相比管腔直径缩小，且差异有统计学意义（P〈0．05）。光镜下观察，实验组右侧颈总动脉内膜撕裂，失去正常连续性，局部可见血小板血栓形成并附着于血管内膜中断处，损伤动脉中层弹力纤维也出现结构紊乱伴纤维不连续，局部有红细胞、淋巴细胞及巨噬细胞沉积。结论动脉内高压注射法制备颅底动脉损伤兔模型制备相对简单，手术风险小，并发症少，组织形态学符合实际损伤结果。模型动物存活时间长，适合研究颅底动脉壁全层损伤的病理生理学机制及后续效应。

Objective To evaluate the animal model of traumatic skull base artery injury （TSBAI） established by the high-pressure intraarterial injection method. Methods Fifty New Zealand rabbits were submitted to high-pressure carotid artery injection （experiment group, n = 20）, tension-free carotid artery injection （sham group, n = 20） and simple carotid artery exposure （control group, n = 10）, according to the random number table. Animal survival was observed. Diameters of carotid artery were measured using the CT angiography （CTA）. Pathological changes of the involved carotid artery were monitored under microscope. Results There were three deaths in experiment group, with the success rate of modeling of 85%. There were two deaths in sham group. M1 animals in control group survived. Diameter of right carotid artery at postoperative one week was （ 1.62 ± 0.10 ）mm in experiment group, reduced compared to （2.25 ± 0. 08 ）mm in sham group and （2.43± 0. 15 ）mm in control group （P 〈 0.05）. For experiment group, intimal tear, loss of normal continuity, and local platelet thrombus formation attaching to the vascular intimal tear were observed in the injured right carotid artery, medialelastic fibers showed structural disorder complicated with discontinuous fibers, and deposition of red blood cells, lymphocytes and macrophages were observed. Conclusions High-pressure intraarterial injection for induction of the TSBAI model is associated with maneuverable operation, low risk, few complications and morphological results conforming to the actual damage. The model can survive for a long time that is suitable for investigating the pathological and physiological mechanism of traumatic skull base artery full- thickness injury and the legacy effect.