建立改良法兔VX2肝癌模型及肝动脉联合门静脉插管的应用

Establishing improved rabbit model bearing VX2liver tumor and application of hepatic artery and portal vein catheterization

目的采用改良法建立兔VX2肝癌模型,探讨经肝动脉联合门静脉插管技术的应用并分析其影响因素。方法对60只健康新西兰大白兔行改良开腹穿刺接种法移植肝癌,并行肝动脉联合门静脉造影,根据术后是否发生短期死亡(术后7天内)分为存活组和死亡组,将可能导致实验兔死亡的因素进行单因素分析,以有统计学意义的指标为自变量,建立二分类Logistic回归模型,分析导致实验兔死亡的独立危险因素。结果 60只实验兔均移植肿瘤成功,9只(9/60,15.00%)实验兔术后短期内死亡,51只(51/60,85.00%)存活。单因素分析显示两组间体质量<2.5kg、术中追加麻醉、手术时间≥60min、切口长度≥5cm及总出血量≥25ml为相关影响因素(P均<0.05)。Logistic回归分析筛选出体质量<2.5kg、术中追加麻醉及出血量≥25ml为手术死亡的独立危险因素(P均<0.01)。结论改良法兔VX2肝癌模型建立成功率较高;选择体重较大的实验兔,同时加强手术技巧的训练,减少术中出血量和避免术中追加麻醉是进行肝动脉联合门静脉造影时降低实验兔死亡率的有效措施。

Objective To establish rabbit model bearing VX2 liver tumor using improved technique,and to analyze the relevant impact factors of hepatic artery and portal vein catheterization.Methods Transplanted liver tumors of 60 healthy New Zealand white rabbits were established through open abdominal puncture and hepatic artery and portal vein catheterization.The rabbits were divided into A group（survival）and B group（death）according to whether a short-term（within 7 days after surgery）death occurred or not.The univariate analysis of the factors which could lead to the death of rabbits were analyzed.The Logisticregression models were established with parameters which were significantly different between the 2 groups,and independent risk factors which could lead to the failure of the experiment were analyzed.Results VX2 tumors were successfully implanted in the liver to all 60 rabbits.Nine（9/60,15.00%）rabbits died within 7 days,while51（51/60,85.00%）rabbits survived.weight〈 2.5 kg,additional intraoperative anesthesia,operation time ≥60 min,length of incision≥5 cm and blood loss of operation≥25 ml were impact factors（all P〈0.05）.Weight〈 2.5 kg,additional intraoperative anesthesia and the blood loss of operation≥25 ml were independent risk factors for death（P〈0.01）.Conclusion Relative high success rate of building rabbit models bearing VX2 liver tumor may achieved using hepatic artery and portal vein catheterization.Larger weight of rabbits,training of surgical skills,less intraoperative blood loss are helpful to avoid intraoperative additional anesthesia,thus reducing mortality of rabbits.