中药血余炭作为血管栓塞剂的实验研究  

An Experimental Study on Crinis Carbonisatus as a Vascular Embolization Agent

作　　者：戴洪修[1] 周建雄[1] 刘卫红[1] 刘克勇[2] 杨定才 赵小华 李达兵 汤和清[1] 梅幸福[1] 陈仁美 

机构地区：[1]三峡大学第一临床医学院放射科 [2]湖北省枝江市人民医院 [3]宜昌市中医院 [4]宜昌市第二人民医院 [5]宜昌市第三人民医院

出　　处：《中国微循环》2006年第4期282-285,共4页Journal of Chinese Microcirculation

基　　金：湖北省重大科技成果;登记号EK050657

摘　　要：目的 用动物实验的方法，观察中药血余炭作为末梢血管栓塞剂的效果、栓塞机理、安全性及相关生物特性。方法 将中药血余炭磨制成200～500μm大小的颗粒，血余炭颗粒（CCP）均以生理盐水加60％泛影葡胺混合。使用Seldinger方法穿刺右股动脉，经导管把血余炭注入到3只犬的左肾动脉，超选栓塞肾脏部分末稍血管；并以PVA注入右肾动脉作对照。在栓塞术后第7、14和56d分别处死1、2和3号犬，取出双肾固定，制作病理标本。结果 （1）3只犬均能耐受麻醉与血管造影和栓塞术，行为状态在栓塞后7d内逐渐恢复正常。（2）组织学标本：在栓塞术后第7、14d，肉眼见肾脏缩小，切面末梢血管内有栓塞剂；镜下见血余炭栓塞剂附着于血管壁，其周围血栓形成；血管壁炎性坏死：血栓逐渐机化。栓塞术后第14d，炎性反应明显，并有少量出血。在栓塞术后第56d见肾脏明显缩小，有大面积的缺血性梗死；镜下见血栓完全机化，栓塞组织呈缺血性梗死，有少量血管再通。CCP维持栓塞的时间在8周以上，属中期栓塞剂。经栓塞术后第7、14和56d病理观察，血余炭栓塞的病理过程为：血余炭附着血管壁，诱发血栓形成，血栓机化，血管壁炎性坏死管腔闭塞，栓塞组织缺血性梗死。结论 血余炭颗粒能有效地栓塞末稍血管，栓塞机理和效果与PVA相仿。炎性反应较PVA重，在栓塞后两周最为明显。Objective To evaluate the efficacy, safety and feasibility of Crinis Carbonisatus particulates（CCP） as a vascular embolization agent by animal exeperiment. Methods Chinese medicine Crinis Carbonisatns was made into particulates with a size 200 to 500μm in diameter. CCPs were delivered into arterioles in left kidneys of three domestic dogs through 4F Cobra catheter under fluoroscopy, Meanwhile, PVA （Ivalon） particulates were injected into vessels in the right kidneys through the same catheter. A super selective renal artery embolization was performed in 3 dogs by using these two materials. Six kidneys were removed and prepared for pathological examination. Histopathologic study of 3 dogs was performed at different intervals after embolization（7th, 14th, 56th days）. Results 3 dogs were well tolerated in anesthetic and endovascular procedures. On examination of the gross kidney specimens, thrombosis of the renal arterioles was noted. During the 8 weeks after embolization, a progressive, marked decrease in renal size occurred. Histopathologic evaluation confirmed satisfactory embolization of peripheral arteries. Acute or chronic inflammatory cells were observed in several vessels containing CCP and PVA microparticles. The occlusion of vessels by CCP lasted at least for 8 weeks when a little recanalization was observed in the target tissue. In disadvantage, CCP resulted in inflammation or a little of focal hemorrhage to surrounding tissues after embolization as gelfoam and PVA did,suggesting some toxicity of this agent. CCP was neither dissolved in water nor suspended in contrast madium properly within a short time. The apparent density of CCP and the specific gravity was not always close to that of whole blood. Consequently, the difficulty of delivering them increased and their radiopaque lacked. Conclusion CCP is capable of producing effective occlusion of distal arteriocapillary nearly to PVA and gelfoam in embolization mechanism.

关 键 词：中药 血余炭 血管 栓塞 栓塞剂 

分 类 号：R322.1[医药卫生—人体解剖和组织胚胎学]