犬房间隔穿刺的方法  

The Establishment of the Method of Canine Atrial Septal Puncture

作　　者：聂振宁[1] 刘少稳[1] 周京敏[1] 林佳雄[1] 陈松文[1] 陶惠伟[1] 葛均波[1] 

机构地区：[1]复旦大学附属中山医院心内科上海市心血管病研究所,上海200032

出　　处：《中国临床医学》2008年第3期285-286,共2页Chinese Journal of Clinical Medicine

基　　金：国家自然科学基金资助项目(项目编号:30570742);上海市浦江人才计划(2006年D类)

摘　　要：目的:对犬行经皮房间隔穿刺术的方法进行初步探讨。方法:健康杂种犬14条,重量29.8±4.5kg(22～34kg),戊巴比妥钠麻醉后,气管插管,仰卧固定,右颈内静脉和股静脉插管,经颈内静脉送10极标测电极入冠状静脉窦。在右前斜45°透视下经股静脉送长导丝及8FSL1长鞘至上腔静脉,换长导丝为穿刺针,回撤至冠状窦口上方1个椎体高度,右前斜位90°透视下同时旋转鞘管和穿刺针,使影像远端弧度消失,然后送穿刺针入左房,并在后前位下注入造影剂证实。结果:12条犬一次性穿刺成功(其中4条犬行2次房间隔穿刺),1条犬在穿刺后不慎将鞘管拔出,再次穿刺成功,1条在穿刺后出现心室停搏,但存在心房电位。术后解剖发现该犬无心包积液,房室结区域损伤。结论:模拟人的房间隔穿刺方法行犬房间隔穿刺,简单易行,可成为犬房颤模型研究中理想的房间隔穿刺方法。Objective：Canine is a usual used model for atrial fibrillation research,and percutaneous atrial septal puncture is needed when exploring the electrophysiological characteristics of left atrium and pulmonary veins or applying radiofrequency ablation.However,the anatomy and relative spatial location of the canine heart are different from that of human.The transseptal puncture method in canine was investigated in this study.Methods：Fourteen hybrid canines,average weight 29.8±4.5Kg（22-34Kg）,were anesthetized with amobarbital,airway tubulated,right internal jugular vein and femoral vein cannulated,and 6F shealths were inserted.Guided by fluoroscopy in the right anterior oblique projection 45°,long guiding wire was forwarded to superior vena cava,then changed to Fast-Cath SL1 sheath and puncture needle,which were pulled back to just one centrum height above the level of coronary sinus os.Then rotated simultaneously the sheath and needle until the distal curve of their images disappeared,pushed the needle.Successful transseptal puncture was confirmed with contrast injection under the fluoroscopy at the posterior-anterior view.Results：Transseptal puncture were carried out successfully just through one procedure in twelve canines（among which four canines accepted puncture twice）.The sheath was inadvertently pulled out in one canine,and repeat transseptal puncture was accomplished.Another canine experienced cardiac arrest,but atrial electrogram still existed.Autopsy ruled out pericardial effusion,found atrioventricular junction area injury in this canine.Conclusion：Successful canine atrial septal puncture is feasible by simulating the method of human atrial septal puncture.

关 键 词：穿刺术 犬 房间隔 

分 类 号：R654.2[医药卫生—外科学]