颈动脉加压旁路的实验研究  

Animal experiment of high-flow bypass of the carotid artery

作　　者：吴雪溪[1] 唐平章[1] 高虹[2] 

机构地区：[1]中国医学科学院中国协和医科大学肿瘤医院头颈外科,北京100021 [2]中国医学科学院中国协和医科大学实验动物研究所,北京100021

出　　处：《中国耳鼻咽喉头颈外科》2005年第9期561-563,共3页Chinese Archives of Otolaryngology-Head and Neck Surgery

基　　金：中国医学科学院中国协和医科大学肿瘤医院2002年临床科研资助项目(TerryFox肿瘤研究基金)

摘　　要：目的颈动脉外科处理动脉血流的方法可分为两类:一是截流法,二是分流法。截流法是阻断一侧颈动脉血流,约30%的患者由于大脑基底动脉环功能不良而产生大脑缺血。分流法是另外建立一条颈动脉到脑动脉的通路,目前存在的缺点是供血量不足。我们设计以下加压旁路装置,试以改进。方法实验动物为大耳白兔,共16只。用27G细针,分别于股动脉和颈动脉颅底端穿刺,两穿刺针之间连接输液管、抗凝输血袋和输液泵。夹闭两侧颈动脉和椎动脉的近心端,阻断向颅内供血。同时启动输液泵,将股动脉的血流加压向颅内灌入。取出大脑作脑组织切片,与正常及缺血模型兔子大脑做对照。结果大脑缺血模型:兔子于5～12分钟内死于脑缺血,大脑外观苍白,组织切片显示大脑缺血表现。股动脉向颈动脉加压灌注血流:全部动物存活,两侧大脑血液灌流一致,组织切片显示正常脑组织。抗凝输血袋起到缓冲池的作用。结论由细针、贮血袋和加压泵组成的动脉旁路,可以减少动脉穿刺损伤,保障大脑供血,为颈动脉手术建立一条临时通路。OBJECTIVE Occlusion and bypass are two ways employed for the carotid surgery. Occlusion of carotid artery on one side may lead to cerebral ischemia in about 30% patients because of the weak Willis circle. The bypass of the carotid is to create another channel to divert the blood flow to the cerebra, but the weakness is the insufficient blood flow it now being able to carry. We designed a high-flow bypass to increase blood supply. METHODS Experimental rabbits were sixteen in total. A pumped high-flow bypass system, which included two 27G fine needles, an anticoagulant plastic bag as a buffer pool, and a transfusion pump, was created between the femoral and the skull end of carotid artery. Clamping the carotid and vertebral arteries on both sides to stop the blood flow, cerebral blood irrigation was maintained by the system pumping the blood flow from the femoral to the carotid. The brain tissue section for histological evaluation was made to compare with the ischemia model. RESULTS The rabbits as the cerebral ischemia model were so died within 5-12 minutes and the brain section showed cerebral ischemia. The high-flow bypass maintained rabbits alive during the experiment time, and the brain section showed normal. The buffer pool kept the balance of pumping blood from the femoral to the carotid. CONCLUSION The pumped high-flow bypass system which consists of fine needles, anticoagulant plastic bag and a transfusion pump proved as a hopeful bypass for carotid surgery, by which the damage to the perforated artery was minimal and the blood supply was sufficient to brain.

关 键 词：颈动脉 动物 实验 颈动脉加压灌注 动脉旁路 实验研 颈动脉血流 大脑缺血 脑缺血模型 脑基底动脉环 

分 类 号：R653[医药卫生—外科学]