经皮肺穿刺猪前腔静脉的实验研究  

Animal experiment of puncture into mediastinum via trans-precava approach

作　　者：刘斌[1] 李培民[2] 李玉亮[1] 王永正[1] 王武杰[1] 王维[1] 李征[1] 

机构地区：[1]山东大学第二医院,济南250033 [2]长治医学院附属和平医院

出　　处：《山东医药》2013年第38期5-7,共3页Shandong Medical Journal

基　　金：山东省科学技术发展计划资助项目(2011GSF11809)

摘　　要：目的评价在CT引导下经猪前腔静脉穿刺技术的可行性与安全性。方法选取6足月的实验用小型猪16头,在CT引导下定位、应用18G带芯穿刺针穿刺猪前腔静脉,观察并记录术前、术中、术后心率、血压、血氧饱和度、血红蛋白含量,术后对猪行强化CT检查,评判有无纵隔血肿、气胸、血胸等并发症。术后处死实验猪,获取前腔静脉穿刺段标本,HE染色后于显微镜下观察穿刺部位情况及血管壁病理变化。结果成功穿刺16头实验猪前腔静脉,无死亡发生。1例出现少量血胸,4例出现少量气胸。术前、术中、术后生命体征平稳,各指标变化差异无统计学意义(P>0.05)。24 h时标本穿刺处内皮移行明显,无明显缺损,肌层尚可见断裂带;72 h时内皮光滑,肌层可见瘢痕修复。结论经猪前腔静脉途径穿刺较为安全,为经上腔静脉途径植入125Ⅰ放射性粒子治疗纵隔淋巴结转移癌提供了一种可行的穿刺途径。Objeetive To investigate the feasibility and safety of puncture into mediastinum via trans-precava approach in pigs.Methods Sixteen experimental miniature pigs was punctured via trans-precava approach with 18G puncture needles under CT guidance.Blood pressure,heart rate,hemoglobin and oxyhemoglobin saturation were recorded before,during and after the procedure.Enhanced contrast CT was performed to estimate complications,such as mediastinal hematoma,pneumothorax or hemathorax.All pigs were sacrificed at 0,24,48,72 h after the procedure respectively,and to get the samples of punctured precava which would be stained by HE staining.Then pathological changes of the samples were observed under the microscope.Results No death occurred,with 1 case of mild hemathorax and 4 of mild pneumothorax.The differences of four designated indexes between before and during the procedure were not significant,as well as those between during and after the procedure （P ＞ 0.05）.Endothelium regeneration and cicatricial adhesion was observed at 24 h and 72 h after the procedure respectively.Conclusion Puncture into mediastinum via trans-precava approach is feasible and safe,which provides a feasible puncture way in treatment of mediastinal lymph node metastatic carcinoma by 125I radioactive particles implantation via trans-precava.

关 键 词：前腔静脉 猪 穿刺 纵隔疾病 放射疗法 

分 类 号：R816.4[医药卫生—放射医学]