体表针刺电刺激诱发心室纤颤猪模型的构建  

A new method for establishing a ventricular fibrillation model by TCEI in Tibetan miniature pig

作　　者：梁国栋[1] 郑汝钢 菅洪健 张旻海 袁慧琼 洪睫敏 武钢[1] LIANG Guodong;ZHENG Rugang;JIAN Hongjian;ZHANG Minhai;YUAN Huiqiong;HONG Jiemin;WU Gang(Department of Emergency Medicine,Nanfang Hospital,Southern Medical University,Guangzhou 510515,China;Emergency Medicine, Fifth Affiliated Hospital of Southern Medical University,Guangzhou 510900,China)

机构地区：[1]南方医科大学南方医院急诊科,广东广州510515 [2]南方医科大学第五附属医院急诊科,广东广州510900

出　　处：《南方医科大学学报》2019年第11期1370-1375,共6页Journal of Southern Medical University

基　　金：广东省省级科技计划项目(2014A020212192)

摘　　要：目的构建一种经济、简便、安全又高效的心脏骤停(CA)猪模型。方法以12只西藏小型猪为研究对象。使用2根针灸针分别穿刺于心脏左右两侧,一根于胸骨右缘第四肋间与胸壁呈30°~60°夹角插入约3 cm,并调整针柄,直至针柄随心脏节律性跳动而心电图未出现室性早搏改变;另一根插入左侧腋下皮下组织约3 cm,以不损伤重要器官为宜。将2根针柄通过导线与3节串联9V干电池组连接,形成回路及直流电刺激。经皮电刺激3 s诱导心室颤动,以构建CA猪模型,记录模型构建成功率。经4 min非干预期后,根据Utstein模式标准对实验动物进行心肺复苏(CPR),并观察该模型复苏后生存情况。结果 12只西藏小型猪通过经皮电刺激诱导室颤,有11只致颤成功,成功率为91.67%(11/12)。动物模型经CPR后,5只实现自主循环恢复(ROSC),复苏成功率为45.45%(5/11)。在后续生存观察中发现:成功复苏的动物24 h存活率达100%(5/5),72 h存活率达80%(4/5)。经72 h观察后对成功复苏的西藏小型猪进行解剖,均未发现实验操作所致的胸腹部重要器官明显损伤。结论利用西藏小型猪,采用针灸针与干电池可以成功构建出相对稳定的CA模型。该模型构建方法具有经济、简便、安全及高效的优势。Objective To explore an economical, convenient, safe and efficient method for establishing a Tibetan miniature pig model of cardiac arrest(CA). Methods Cardiac puncture was performed in 12 Tibetan miniature pigs using two acupuncture needles. One needle was inserted into the fourth intercostal near the right side of the sternum about 3 cm in depth at an angle of 30° to 60° between the chest and the needle, and the depth was adjusted until the handle of the needle vibrated with the heartbeat without premature ventricular contraction on the electrocardiogram;the other was inserted into the subcutaneous tissue of the left armpit about 3 cm in depth without damaging important organs. The handles of the two needles were connected with 9 V dry batteries to form a circuit and generate direct current stimulation. Ventricular fibrillation was produced in the pigs to induce CA by stimulation of transcutaneous electrical induction(TCEI) for 3 s, and the success rate of modeling was recorded. After an interval of 4 min without intervention, cardiopulmonary resuscitation(CPR) was performed using the standard Utstein style, and the survival of the pigs after recovery was observed. Results The success rate of ventricular fibrillation modeling was 91.67%(11/12) using this method, and CPR achieved a success rate of 45.45%(5/11) in these models.The subsequent survival of the pigs was 100%(5/5) at 24 h and 80%(4/5) at 72 h. After observation for 72 h, the resuscitated Tibetan miniature pigs were dissected, and no significant damage was found in the vital organs in the thoracic or abdominal cavities. Conclusion We successfully established a model of CA using acupuncture needles and dry batteries in Tibetan miniature pigs, and this method is economical, convenient, safe and efficient.

关 键 词：心源性猝死 心脏骤停 心室颤动 针灸针 西藏小型猪 动物模型 

分 类 号：R54[医药卫生—心血管疾病]