新型无血预充体外循环深低温停循环模型  

A novel deep hypothermic circulatory arrest model without blood priming

作　　者：张帅 刘杨[1] 蒋璇[2] 谷天祥[2] ZHANG Shuai;LIU Yang;JIANG Xuan;GU Tian-xiang(Pediatric Thoracic and General Surgery,Shengjing Hospital of China Medical University,Shenyang 110001,China;Cardiac Surgery,First Affiliated Hospital of China Medical University,Shenyang 110001,China)

机构地区：[1]中国医科大学附属盛京医院小儿普外胸外新生儿外科,辽宁省沈阳市110001 [2]中国医科大学附属第一医院心脏外科

出　　处：《中国心血管病研究》2020年第7期647-651,共5页Chinese Journal of Cardiovascular Research

基　　金：国家重点研发计划重大慢性非传染性疾病防控研究重点专项(2017YFC1308000)。

摘　　要：目的通过对临床使用材料进行改进,建立一种新型的安全的无血预充的小动物深低温停循环(deep hypothermic circulatory arrest,DHCA)模型,以满足DHCA并发症病理生理的研究.方法取20只成年SD大鼠(14~16周,200~300 g).体外循环(cardiopulmonary bypass,CPB)管道由改良储血器、定制的小动物膜肺、滚压泵和硅胶管道以及自制热交换管道,管道预充量不足10 ml.右颈静脉、右颈动脉及左股动脉插管,右心房血液通过右颈静脉插管引流,通过左股动脉进行灌注.体外循环流量为全流量,大鼠体温降至18℃并进行45 min全身停循环,随后进行60 min复温.管道内血液离心并回输浓缩红细胞.在术中实时记录血流动力学及体外循环指标.结果20例CPB及DHCA过程均成功完成.实验中无大鼠死亡.各时间点血气分析均正常.术后心率为(346.5±3.51)次/min,血压为(72.6±2.84)mm Hg,红细胞压积为(34.5±3.6)%.结论新型无血预充深低温停循环大鼠模型可以安全建立.Objective To establish a novel and safe deep hypothermic circulatory arrest(DHCA)model without blood priming in rats to study the pathophysiology of potential complications.Methods Twenty adult male Sprague-Dawley rats(age:14-16 weeks;weight:200-300g)were used.The entire cardiopulmonary bypass(CPB)circuit consisted of a modified reservoir,a custom-designed small-volume membrane oxygenator,a roller pump and a home-made heat exchanger,all of which were connected via silicon tubing.The volume of the priming solution was less than 10 ml.The right jugular vein,right carotid artery and left femoral artery wero cannulated.The blood was drained from the right atrium through the right jugular vein and fed back to the rat via the left femoral artery.CPB was commenced at a full flow rate.The animals were cooled to a pericranial temperature of I8C and then subjected to 45 minutes of DHCA with global ischemia.Circulatory arrest was followed by rewarming and over 60 minutes of reperfusion.CPB was terminated carefully.Blood in the circuit was centrifuged and slowly transfused to achieve optimal hematocrit.Blood gas and hemodynamic parameters were recorded at each time point before CPB,during CPB and after CPB.Results Twenty cases of CPB and DHCA processcs were achieved successfully.No rat died in the experiment.Blood gas analyses at different times were normal.Postoperative mean heart rate was(346.5±3.51)beats per minute,postoperative blood pressure was(72.6±2.84)mm Hg and postoperative mean heamatocrit was(34.5±3.6)%.Conclusion The novel augmented venous-drainage CPB and DHCA model in rats could be established successfully without blood priming.

关 键 词：体外循环 深低温停循环 动物模型 脑保护 

分 类 号：Q95-33[生物学—动物学] R654.2[医药卫生—外科学]