通过置入支架建立大鼠肝内门体分流模型  

A rat model of intrahepatic portosystemic shunt established by stent implantation

作　　者：张晗 肖江强[1] 韩浩[2] 乔香梅 赵思 诸葛宇征[1] ZHANG Han;XIAO Jiangqiang;HAN Hao;QIAO Xiangmei;ZHAO Si;ZHUGE Yuzheng(Department of Gastroenterology,Affiliated Nanjing Drum Tower Hospital,Medical School of Nanjing University,Nanjing,Jiangsu Province 210008,China)

机构地区：[1]南京大学医学院附属鼓楼医院消化内科,江苏南京210008 [2]南京大学医学院附属鼓楼医院超声诊断科,江苏南京210008

出　　处：《介入放射学杂志》2023年第8期769-773,共5页Journal of Interventional Radiology

基　　金：国家自然科学基金(8210032706)。

摘　　要：目的通过置入支架建立大鼠肝内门体分流模型。方法将25只雄性SD大鼠随机分为分流手术组15只,假手术组10只。分流手术组大鼠行腹部正中切口后暴露门静脉并穿刺,穿刺成功后经该途径肝内穿刺肝背段下腔静脉,并利用穿刺针引导,将自制支架置入肝内连接门静脉及下腔静脉,建立门体分流道。假手术组仅行开腹、关腹操作。术后通过门静脉内置管行直接门静脉造影,观察分流道通畅情况,并于术后2 h及4 d行腹部B超,监测支架内血流速度,术后第3天取大鼠外周血完成血常规、肝功能、血氨等检查。结果分流手术组大鼠术后存活14只,术后即时直接门静脉造影,见大鼠门脉主干及肝上下腔静脉几乎同时显影,术后2 h超声结果提示,8只手术成功。其中支架在位的8只大鼠中,6只支架血流通畅,血流速度22~68 cm/s,术后4 d超声结果提示支架均未移位,但术后2 h支架通畅的6只大鼠中仅有1只大鼠支架仍保持通畅,其余支架内均形成完全血栓。分流手术组与假手术组间术后3 d的ALT、AST、总胆汁酸(TSA)、血红蛋白及血小板计数差异均无统计学意义(均P>0.05),但白细胞及血氨水平分流手术组显著高于假手术组(均P<0.05)。结论通过开腹后直接穿刺大鼠门静脉置入肝内门体分流支架是安全可行的。Objective To establish a rat model of intrahepatic portosystemic shunt by using stent implantation method.Methods A total of 25 male SD rats were randomly divided into portosystemic shunt group(group A,n=15)and sham operation group(group B,n=10).For the experimental rats of group A,the portal vein was exposed and punctured after a median abdominal incision was made,which was followed by the puncturing of the hepatic dorsal inferior vena cava,then under the guidance of the puncture needle a selfmade stent was inserted into the liver to establish a portosystemic shunt.For the experimental rats of group B,only laparotomy and abdominal closure were carried out.Postoperative direct portal venography was performed to check the patency of the shunt channel.Abdominal ultrasonography was performed at 2 hours and 4 days after operation to determine the in-stent blood flow velocity.On the third day after operation,the peripheral blood sampling was made to complete the examinations of blood routine,liver function,blood ammonia,etc.Results In group A,the postoperative overall survival rate was 93.3%(14/15),and the direct portal angiography immediately after surgery showed that visualizations of the main portal vein and hepatic vena cava were almost simultaneously observed.Ultrasonography performed 2 hours after the operation showed that successful surgery was accomplished in 8 rats.Of the 8 rats in which the implanted stent was in right place,the stent blood flow was unobstructed in 6,and the blood flow velocity ranged from 22 cm/s to 68 cm/s.The postoperative 4-day ultrasonography revealed that none of the stents were displaced,but of the 6 rats showing unobstructed stent at 2 hours after surgery only in one rat the stent remained unobstructed,and in all the other rats a complete thrombus was formed within the stents.No statistically significant differences in ALT,AST,total bile acids(TBA),hemoglobin and platelet count existed between group A and group B(all P>0.05),while the white blood cell count and blood ammonia level in

关 键 词：大鼠 肝内门体分流 动物模型 

分 类 号：R657.3[医药卫生—外科学]