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中华医学超声杂志（电子版）

中华医学超声杂志（电子版） ›› 2021, Vol. 18 ›› Issue (04) : 407 -411. doi: 10.3877/cma.j.issn.1672-6448.2021.04.012

所属专题： 文献；

基础研究

超声引导下髂动脉破裂出血模型的建立
黄钰清1, 吴盛正2, 陈祥慧2, 单雪霞2, 林星禧2, 张立业2, 周璇3, 吕发勤4,†()   
  1. 1. 100853　北京，解放军医学院
    2. 572013　三亚，解放军总医院海南医院超声科
    3. 100853　北京，解放军总医院第一医学中心急诊科
    4. 100853　北京，解放军医学院；572013　三亚，解放军总医院海南医院超声科
  • 收稿日期:2020-06-16 出版日期:2021-04-01
  • 通信作者: 吕发勤
  • 基金资助:
    海南省重大科技计划项目(ZDKJ2019012); 科技部“十三五”国家重点研发计划项目(2016YFC0105006); 解放军总医院军事医学创新研究项目(CX19025); 三亚市医疗卫生科技创新项目(2018 YW01)

Establishment of an animal model of iliac artery hemorrhage under ultrasound guidance

Yuqing Huang1, Shengzheng Wu2, Xianghui Chen2, Xuexia Shan2, Xingxi Lin2, Liye Zhang2, Xuan Zhou3, Faqin Lyu4,†()   

  1. 1. Medical School of Chinese PLA, 100853 Beijing, China
    2. Department of Ultrasound, Hainan Hospital of PLA General Hospital, 572013 Sanya, China
    3. Emergency Department, the First Medical Centre of PLA General Hospital, 100853 Beijing, China
    4. Medical School of Chinese PLA, 100853 Beijing, China; Department of Ultrasound, Hainan Hospital of PLA General Hospital, 572013 Sanya, China
  • Received:2020-06-16 Published:2021-04-01
  • Corresponding author: Faqin Lyu
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黄钰清, 吴盛正, 陈祥慧, 单雪霞, 林星禧, 张立业, 周璇, 吕发勤. 超声引导下髂动脉破裂出血模型的建立[J]. 中华医学超声杂志（电子版）, 2021, 18(04): 407-411.

Yuqing Huang, Shengzheng Wu, Xianghui Chen, Xuexia Shan, Xingxi Lin, Liye Zhang, Xuan Zhou, Faqin Lyu. Establishment of an animal model of iliac artery hemorrhage under ultrasound guidance[J]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2021, 18(04): 407-411.

目的

探讨超声引导下使用一次性穿刺活检装置制备髂动脉破裂出血模型的可行性。

方法

选用实验动物五指山猪9只，均为雄性，体质量为（14.06±0.31）kg。超声引导下经颈内静脉穿刺留置中心导管给予限量补液及麻醉维持。经颈总动脉穿刺置管并连接压力换能器，通过生物信号采集处理系统连续监测有创动脉血压和心率。在超声引导下使用一次性穿刺活检装置在实验猪的一侧髂动脉进行穿刺，通过二维超声及彩色多普勒超声观察建模前后髂动脉管腔形态及血流动力学变化，以及腹腔及腹膜后积血量。出血30 min后处死动物并进行解剖，采集两侧髂动脉血管标本。

结果

建模后9只实验动物均出现髂动脉破裂出血，较建模前血压降低［收缩压：（120.33±16.69）mmHg vs（84.56±13.43）mmHg，P＜0.05；舒张压：（75.11±16.57）mmHg vs（59.44±19.01）mmHg，P＜0.05］，心率增快［（77.89±22.98）次/分 vs（111.33±26.18）次/分，P＜0.05］，符合失血性休克的表现。建模后二维超声及彩色多普勒超声可观察到髂动脉内血流变细、动脉塌陷，较建模前髂动脉内径减小［（0.39±0.63）cm vs（0.22±0.54）cm，P＜0.05）、腹腔内无回声区逐渐扩大［（0.13±0.12）cm vs（3.03±0.99）cm，P＜0.05］。解剖后可观察到腹腔及腹膜后出现巨大血凝块，大体标本可显示髂总动脉破裂口。

结论

应用超声引导下穿刺活检的方法可以建立实验猪髂动脉破裂出血模型，方法简便易行，模型稳定，成功率高。

关键词: 超声检查, 髂动脉, 出血, 猪, 动物模型, 穿刺术
Objective

To explore the feasibility of establishing an animal model of iliac artery hemorrhage under ultrasound guidance.

Methods

The experimental animals used in this study were nine male Wuzhishan pigs with a mean weight of (14.06±0.31) kg. Limited fluid resuscitation and application of anesthetic through an internal jugular vein indwelling catheter were given. Invasive arterial blood pressure (ABP) and heart rate (HR) were recorded using a biological signal collection and processing system connected with a pressure transducer via the arteria carotis connect. Under the guidance of ultrasound, a disposable puncture biopsy device was used to puncture one side of the iliac artery. The changes in the luminal shape and hemodynamics of the iliac artery and the volume of retroperitoneal blood accumulation were observed by ultrasound and color Doppler ultrasound. Thirty minutes after hemorrhage, the animals were sacrificed for anatomy, and the specimens of both sides of the iliac artery were collected.

Results

The rupture of the iliac artery occurred in all nine experimental animals. After puncturing the iliac artery, blood pressure fell [systolic pressure: (120.33±16.69) mmHg vs (84.56±13.43) mmHg, P＜0.05; diastolic pressure: (75.11±16.57) mmHg vs (59.44±19.01) mmHg, P＜0.05] and heart rate increased [(77.89±22.98) bpm vs (111.33±26.182) bpm, P＜0.05), which was consistent with hemorrhagic shock. The artery rapidly collapsed and the inner diameter of the artery narrowed [(0.39±0.63) cm vs (0.22±0.54) cm, P＜0.05]. The maximum depth of ascites increased gradually [(0.13±0.12) cm vs (3.03±0.99) cm, P＜0.05]. After the animals were sacrificed and the abdomen was opened, huge blood clots in the abdominal and retroperitoneum were visible. The gross pathological findings confirmed the rupture of the right iliac artery.

Conclusion

It is feasible to establish an animal model of iliac artery hemorrhage under the guidance of ultrasound. This method is simple and has a high success rate.

Key words: Ultrasonography, Iliac artery, Hemorrhage, Swine, Animal model, Punctures
图1 建模时所用的MaxCore一次性穿刺活检装置
表1 实验动物髂动脉破裂出血模型建立前后一般情况比较（
xˉ
±s）
时间 数量（只） 收缩压（mmHg） 舒张压（mmHg） 心率（次/分） 腹腔积液量（cm） 髂动脉内径（cm）
建模前 9 120.33±16.69 75.11±16.57 77.89±22.98 0.13±0.12 0.39±0.63
建模后 9 84.56±13.43 59.44±19.01 111.33±26.18 3.03±0.99 0.22±0.54
t值 14.89 3.21 -5.30 -9.16 6.10
P值 0.00 0.01 0.01 0.00 0.02
图2 超声引导下髂动脉破裂模型的制备。图a为超声引导下使用一次性穿刺活检针抵达髂动脉前侧壁（箭头所示为穿刺针尖）；图b为击发活检装置后，腹膜后和腹腔积液不断增加，透声差，可见密集点状回声，动态观察成漩涡状（箭头所示为腹腔积液)
图3 髂动脉破裂模型建模前后彩色多普勒超声图像。图a为建模前彩色多普勒超声显示髂动脉内径为0.30 cm，血流充盈良好；图b为建模后即刻彩色多普勒超声显示髂动脉血流变细、动脉塌陷，内径为0.22 cm，周围血肿压迫髂静脉，其内未见血流信号
图4 髂动脉破裂成模动物解剖后大体标本。图a为处死动物，打开腹腔可见腹膜后较大血凝块（箭头所示）；图b为腹膜后血凝块之一；图c为腹主动脉及两侧髂动脉标本（箭头所示为髂总动脉破裂处）
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