兔后肢继发淋巴水肿模型的建立  

Establishment of secondary lymphedema model in rabbit hind limb

作　　者：钱幼蕾 穆籣 QIAN Youlei;MU Lan(Department of Lymphatic Surgery,Beijing Shijitan Hospital,Beijing 100038,China;Department of Breast Surgery,the Second Affiliated Hospital of Hainan Medical University,Haikou 570311,China)

机构地区：[1]首都医科大学附属北京世纪坛医院淋巴外科,北京100038 [2]海南医学院第二附属医院乳腺外科,海口570311

出　　处：《中华显微外科杂志》2024年第5期560-566,共7页Chinese Journal of Microsurgery

基　　金：北京大学人民医院发展基金学科培育项目(RDD2016-05)。

摘　　要：目的建立兔后肢继发淋巴水肿模型,应用吲哚菁绿(ICG)淋巴管造影对模型进行评估。方法本研究于2017年3月至2018年3月,在北京大学人民医院动物实验中心以7只雌性新西兰白兔为实验对象,以兔右后肢为对照侧,左后肢为实验侧。实验侧后肢采用单纯手术法(清扫腹股沟淋巴结,清除股血管周围淋巴组织,环形清除5.0 cm宽皮下组织)建立兔后肢淋巴水肿模型。术后24周通过后肢周径和体积测量、ICG造影和组织学观察对模型进行评估。连续性变量用均数±标准差(Mean±SD)表示,其比较用t检验;计数资料用例(%)表示。所有统计分析用SPSS 26.0软件包完成。双侧检验P<0.05表示差异有统计学意义。结果7只雌性新西兰白兔中1只于建模时死亡,剩余6只术后24周淋巴水肿出现率为83.3%(5/6),所有兔的后肢淋巴管结构及功能均受损。后肢周径和体积在术后20~24周逐渐趋于稳定,术后24周实验侧膝上2 cm周径[(17.58±0.23)cm]大于对照侧[(16.65±0.47)cm],差异有统计学意义(P<0.01),同时实验侧膝周径[(15.23±0.47)cm]大于对照侧[(14.42±0.51)cm],差异有统计学意义(P=0.018)。实验侧小腿中部周径、踝周径、足中部周径及体积均大于对照侧,但差异无统计学意义(P>0.05)。术后24周ICG造影提示,6只新西兰白兔实验侧肢体均出现明显的淋巴管形态改变、淋巴液瘀滞与皮肤淋巴反流等淋巴管结构及功能损伤表现;组织学检查见实验侧肢体皮肤表面角化层增生,真皮层增厚,皮下淋巴管增多、扩张,股动、静脉之间纤维增生且未见集合淋巴管。结论单纯手术法可诱导兔后肢继发性淋巴水肿的发生,且ICG造影可有效评估继发性淋巴水肿。Objective To establish an animal model of secondary chronic lymphedema using rabbit hind limb and evaluate it with indocyanine green(ICG)lymphangiography.Methods From March 2017 to March 2018,a secondary lymphedema model of rabbit hind limb was established in 7 rabbits in the Animal Experimental Centre of Peking University People's Hospital.The right hind limb of the rabbit was the control side,and the left hind limb was the experiment side which using simple surgical induction(dissection of inguinal lymph nodes,removal of lymph tissue around femoral vessels,and circumferential removal of subcutaneous tissue in 5.0 cm wide).Measurement of limb circumference and volume,ICG lymphangiography and histology were applied to evaluate the rabbit model 24 weeks after surgery.Continuous variables were presented as Mean±SD,the differences were compared using Student t test.Use the count data case(%)to represent it.All statistical analyses were performed using SPSS software version 26.0.A two-sided P<0.05 was considered statistically significant.Results Among 7 female New Zealand white rabbits,1 died in modeling,5 of the remaining 6 rabbits developed lymphedema(83.3%)(5/6)at 24 weeks after surgery.Impaired structure and function of lymphatic vessels was found in all the rabbits.Circumference and volume of the experimental hind limbs tended to be stable at 20-24 weeks after surgery,and the circumference at 2 cm above knee on the experiment side(17.58 cm±0.23 cm)was greater than that on the control side(16.65 cm±0.47 cm)at 24 weeks after surgery with statistical significance(P<0.01).The circumference of knee on the experiment side(15.23 cm±0.47 cm)was greater than that on the control side(14.42 cm±0.51 cm)with statistical significance(P=0.018).The circumferences at the plane of middle calf,ankle,middle foot,and volume on the experimental side were all greater than those on the control side,without statistical significance.At 24 weeks after surgery,ICG lymphangiography showed that all 6 affected hind limbs of the rabbits h

关 键 词：继发性淋巴水肿 吲哚菁绿 淋巴管造影 淋巴水肿模型 兔 

分 类 号：R551.2[医药卫生—血液循环系统疾病]