摘要
目的应用球囊导管建立实验兔急性可控性气管狭窄模型,研究气管狭窄程度与血氧饱和度及呼吸频率间关系。方法将34只新西兰大白兔随机分为对照组(n=4)和实验组(n=30,设A、B、C、D、E 5个亚组,n A^E=6)。对照组兔全身麻醉后行气管切开及气管插管,DSA三维重建测量气管插管下方气管横径和纵径,并记录麻醉前、麻醉-气管切开后及切开后30 min血氧饱和度及呼吸频率;实验组兔气管切开后在气管插管下方管腔置入球囊或球囊+单弯导管:A组球囊直径3 mm,B组球囊直径3.5 mm,C组球囊直径4.0 mm,D组球囊直径4 mm(+4 F单弯导管),E组2个球囊直径分别为4 mm和2 mm,球囊置入前后分别行DSA三维气管重建,测量气管切开处下方气管横径和纵径及扩充球囊最大半径,计算气管狭窄率并记录麻醉前、麻醉-气管切开后及球囊扩充后最终血氧饱和度及呼吸频率。结果对照组和实验组间及实验组各亚组间兔体重、气管横截面积差异无统计学意义(P>0.05);3%戊巴比妥钠(1 ml/kg)全身麻醉对兔血氧饱和度及呼吸频率无明显影响(P>0.05);2.8~3.5 kg兔体重与气管横截面积间无明显线性相关性(r=0.41,P=0.23);实验组A、B、C、D、E组气管狭窄率分别为(39.87±1.43)%、(52.16±2.46)%、(68.77±2.48)、(76.82±2.75)%、(86.49±2.42)%,各组间差异均有统计学意义(P<0.05),E组狭窄率最大;A、B组气管狭窄率与狭窄后最终血氧饱和度及呼吸频率无明显相关性(r=0.054,P=0.86;r=0.11,P=0.72),C、D、E组中气管狭窄率与狭窄后最终血氧饱和度呈显著负相关性(r=-0.85,P<0.01),与狭窄后呼吸频率呈显著正相关(r=0.92,P<0.01)。结论气管狭窄达到一定程度时,随狭窄程度增加,呼吸功能障碍加重。采用扩张球囊制作兔气管狭窄模型是一种快速、可控性强、操作简单、稳定、重复性好的方法,可为气管狭窄基础研究和临床治疗提供有效可靠的实验载体。
Objective To establish a rabbit model of acute controllable tracheal stenosis by using balloon catheter, and to explore the relationship between blood oxygen saturation, respiratory frequency and the degree of tracheal stenosis. Methods Thirty-four New Zealand white rabbits were randomly divided into the control group （n=4） and experiment group （n=30）, which was equally subdivided into subgroup A, B, C, D and E with 6 rabbits in each subgroup. Under general anesthesia, tracheal incision and tracheal intubation were performed in the rabbits of the control group; DSA 3D reformation was conducted to measure the tracheal transverse diameter and longitudinal diameter below the tracheal intubation level, and the oxygen saturation and breathing frequency were respectively recorded before anesthesia, immediate after tracheal incision and 30 rain after tracheal incision. For the rabbits of the experimental group, after tracheal incision and tracheal intubation, a balloon catheter or balloon±single curved catheter was inserted into the air lumen below the tracheal intubation level; the diameter of balloon used in the rabbits was 3 mm for the subgroup A, 3.5 mm for the subgroup B, 4.0 mm for the subgroup C, 4 mm （±4 F single curved catheter） for the subgroup D, and 4 mm and 2 mm for the subgroup E. 3D reformation of the trachea was performed before and after the balloon was inserted; the transverse diameter and longitudinal length as well as the maximum diameter of the dilated balloon below the tracheal incision level were recorded, the tracheal stenosis ratio was calculated, and the final oxygen saturation and breathing frequency were respectively recorded before anesthesia, immediate after tracheal incision and after balloon expansion. Results No significant differences in the body weight, tracheal cross- sectional area existed between the control group and the experimental group, as well as between the subgroups of the experimental group （P〉0.05）. Genera/anesthesia （1 ml/kg of 3% pentobarbital sodium） had no obvious effect on oxygen saturation and breathing frequency of the rabbits （P〉0.05）. Body weight of 2.8-3.5 kg had no significant linear correlation with the trachea cross-sectional area （r=0.41, P= 0.23）. The tracheal stenosis ratios of the subgroup A, B, C, D and E were （39.87±1.43）%, （52.16±2.46）%, （68.77±2.48）%, （76.82±2.75）% and （86.49±2.42）% respectively ; statistically significant differences existed between each other among the five subgroups （P〈0.05）, with the tracheal stenosis ratio of subgroup E being the biggest. In subgroup A and B, the tracheal stenosis ratio showed no obvious correlation with the final oxygen saturation and breathing frequency （r=0.054, P=0.86; r=0.11, P=0.72）; in subgroup C, D and E, the tracheal stenosis ratio bore a significant negative correlation with the final oxygen saturation （r=-0.85 ,P〈 0.01 ）, while a significant positive correlation with the breathing frequency （r=0.92, P〈0.01 ）. Conclusion When the degree of tracheal stenosis reaches a certain level, the respiratory dysfunction become worse with the increase of the degree of stenosis. The use of balloon dilatation to establish the rabbit model of tracheal stenosis is fast, strong controllable, simple-manipulated, stable and repeatable; the models can provide reliable experimental cartier for basic research and clinical treatment of tracheal stenosis.
出处
《介入放射学杂志》
CSCD
北大核心
2015年第8期707-712,共6页
Journal of Interventional Radiology
基金
徐州市医学科研课题(XWJ2011017)
徐州医学院附属医院医学科技项目(2013104035)
徐州医学院“振兴计划”项目(XZMC20122015)
关键词
新西兰大白兔
球囊导管
气管狭窄
动物模型
New Zealand white rabbit
balloon catheter
tracheal stenosis
animal model
