大鼠正中开胸升主动脉根部阻断灌注心脏停搏液体外循环模型的建立  

Open chest cardiopulmonary bypass,cardioplegia perfusion on aortic root by ascending aorta occlusion:a new experimental rat model on cardiac surgery study

作　　者：仇冰梅 王雷[2] 丁培成 章兴 许汝坤 胡兰鑫 王安立 Qiu Bingmei;Wang Lei;Ding Peicheng;Zhang Xing;Xu Rukun;Hu Lanxin;Wang Anli(Department of Cardiothoracic Surgery,General Hospital of Eastern Theater Command,Jinling Hospital,Jiangsu Nanjing 210002,China)

机构地区：[1]南京大学医学院附属金陵医院(东部战区总医院)心胸外科,南京210002 [2]南京医科大学南京市第一医院心外科,南京210006 [3]南京医科大学南京市第一医院麻醉科,南京210006 [4]南京医科大学南京市儿童医院心胸外科,南京210008

出　　处：《中国体外循环杂志》2024年第4期313-317,323,共6页Chinese Journal of Extracorporeal Circulation

基　　金：东部战区总医院院管课题(22JCYYZD11)。

摘　　要：目的建立大鼠正中开胸模拟心肺转流(CPB)升主动脉根部阻断灌注心脏停搏液心脏停搏及复苏过程。方法选取10只成年雄性SD大鼠350~450 g,吸入诱导及腹腔注射麻醉后气管插管接小动物呼吸机辅助通气。右颈内静脉穿刺自制带侧孔引流管,尾动脉灌注建立体外循环,股动脉监测血压。CPB开始,正中开胸,暴露心脏,阻断升主动脉,经升主动脉根部灌注心脏停搏液,阻断30 min后开放升主动脉,予以氯化钙、小剂量肾上腺素、速尿,待血流动力学稳定及血气调整满意后停机。分别于CPB开始前、CPB开始、CPB 10 min、升主动脉阻断、阻断10 min、20 min、开放升主动脉、停机、停机后2 h采集血液进行血气分析并观察停机后大鼠血流动力学指标。结果7只大鼠成功建模,1只在开胸过程中呼吸心跳骤停,1只颈内静脉穿刺失败出血性休克死亡,1只颈内静脉插管过深刺激窦房结导致心脏骤停。转机时间(72±12)min,后并行时间(21±6)min,CPB期间红细胞压积显著低于基线生理值,各检测点血气均符合CPB正常标准要求。结论大鼠正中开胸CPB升主动脉阻断模型是一种成本低廉、稳定可靠的实验模型,可以作为心脏手术患者器官损伤、心肌保护等的替代研究。Objective To establish the process of cardiac arrest and resuscitation in rats with median thoracotomy to simulate cardiopulmonary bypass(CPB)by injecting cardioplegic solution from the ascending aorta root.Methods 10 adult male SD rats were selected(weight ranging from 350 g to 450 g).Inhalation induced and intraperitoneal injection anesthesia was followed with endotracheal intubation and small animal ventilator-assisted ventilation.The right internal jugular vein was inserted by a self-made drainage tube with lateral holes serving as venous drainage while the tail artery was intubated as arterial perfusion to establish CPB,the femoral artery was intubated and monitored for blood pressure.At the beginning of CPB,median thoracotomy was performed,the heart was exposed,and the ascending aorta was clamped.Cardioplegia was perfused through the root of the ascending aorta root.After 30 minutes of clamping,the ascending aorta was re-opened,and calcium chloride,small doses of epinephrine and furosemide were administered.Blood samples were collected before CPB,at the beginning of CPB,10 min after CPB,at the beginning of aortic clamping,10 and 20 minutes after clamping,aorta re-open,CPB weaned off and 2 hours after CPB weaned off for blood gas analysis.Additionally hemodynamics of rats were observed after CPB weaned off.Results 7 rats successfully underwent modeling,while one suffered cardiac arrest during the thoracotomy procedure,one died of hemorrhagic shock due to faild internal jugular vein intubation,another died of cardiac arrest because of arrythmia due to jugular vein intubation.CPB time was 72±12 min,post-resuscitation parallel circulation time was 21±6 min.Hematocrit level during CPB was significantly lower than baseline,the results of blood gas analysis at each measurement point remained acceptable as CPB standard.Conclusion The CPB with median thoracotomy and ascending aorta occlusion model in rats is a low-cost,stable and reliable experimental model,which can be used as an alternative study tool of organ i

关 键 词：大鼠 动物模型 体外循环 正中开胸 升主动脉阻断 心肌保护 

分 类 号：R654.1[医药卫生—外科学] R-332[医药卫生—临床医学]