下腔静脉造影指导犬房间隔穿刺术  

Atrial septal puncture in dogs guided by inferior vena cava angiogram

作　　者：董建增 曹林生[1] 马长生[2] 聂绍平[2] 刘兴鹏[2] 张崟[2] 王京 刘小青[2] 龙得勇[2] 

机构地区：[1]武汉市华中科技大学同济医学院附属协和医院心血管病研究所,430022 [2]首都医科大学附属北京安贞医院心内科北京市心肺血管研究所

出　　处：《中国介入心脏病学杂志》2005年第2期111-113,共3页Chinese Journal of Interventional Cardiology

摘　　要：目的　介绍下腔静脉造影指示下犬房间隔穿刺术方法。方法　对9只健康杂种犬进行了下腔静脉造影指示下的房间隔穿刺术。全麻下经皮穿刺右侧股静脉,X线投照角度RAO 30°,经Mullins鞘管注射76 %的泛影葡胺2 0mL行下腔静脉造影,分别显示下腔静脉及其开口、右心房影、左心房影和主动脉根部影,将Brockenbrough穿刺针远端弯度的近端塑形增加1个弯度,使穿刺针方向指示器指向3点左右、针尖顶至房间隔进行穿刺。结果　( 1 )下腔静脉造影显示与房间隔穿刺有关的解剖特征为下腔静脉开口位置高,全部在房间隔中上部,使房间隔穿刺点位置也高,加上左心房腔小,穿刺针易穿至左心房顶部;( 2 )下腔静脉造影指导下房间隔穿刺术成功率为1 0 0 % ( 9/ 9) ,心脏压塞1例,经X线和造影剂指示心包穿刺引流术控制。结论　下腔静脉造影指导下的经皮犬房间隔穿刺术简单易行。Objective To introduce the method of atrial septal puncture guided by inferior vena cava angiogram in dogs. Methods Atrial septal puncture had been carried out in 9 normal dogs under the guiding of inferior vena cava (IVC) angiogram, which was done by injecting 20 mL of contrast medium through the Mullins sheath under 30° of right anterior oblique (RAO) view. Another curve was shaped proximal to the distal curve of Brochenbrough puncture needle, atrial septal puncture was carried out with the indicator of the puncture needle pointing at 3 o′clock and toward the atrial septal, the outer sheath was then inside the left atrium. Results (1) Special anatomy associated with atrial septal puncture demonstrated by IVC angiogram including: IVC ostia in dogs are higher than that in human beings, the exact level of IVC ostium is in the upper part of atrial septal; and left atrium chamber are smaller than that in human beings, left atrium roof tended to be perforated during procedures; (2) Guided by IVC angiogram, success rate of atrial septal puncture was 100% (9/9), tamponade developed in one dog, which was controlled by pericardiocentesis. Conclusion Percutaneous puncture of atrial septal under the guiding of IVC angiogram can be performed easily in dogs.

关 键 词：下腔静脉造影 房间隔穿刺术 心包穿刺引流术 右侧股静脉 主动脉根部 穿刺点位置 左心房顶部 穿刺针 经皮穿刺 投照角度 泛影葡胺 开口位置 解剖特征 造影显示 心脏压塞 杂种犬 右心房 指示器 心房腔 造影剂 X线 弯度 

分 类 号：R657.34[医药卫生—外科学] R541.710.5[医药卫生—临床医学]