中国血液净化

中国血液净化 ›› 2021, Vol. 20 ›› Issue (09): 612-616.doi: 10.3969/j.issn.1671-4091.2021.09.009

• 基础研究 • 上一篇    下一篇

应用改良No-touch 技术建立兔颈总动脉-颈外静脉内瘘模型

刘振1,王晓禾1,王加英1,张元元1,侯国存1   

  1. 1南京医科大学附属苏州科技城医院肾内科(刘振和王晓禾为共同第一作者)
  • 收稿日期:2021-03-23 修回日期:2021-05-20 出版日期:2021-09-12 发布日期:2021-09-12
  • 通讯作者: 侯国存 doctorhougc@njmu.edu.cn E-mail:houguocun2007@aliyun.com
  • 基金资助:
    苏州市科技计划项目(SYS2020077)；苏州高新区医疗卫生科技计划项目(2020Z001)

The construct of common carotid artery-external jugular vein arteriovenous fistulas in rabbit model by a modified no-touch technique

  1. 1Department of Nephrology, The Affiliated Suzhou Science & Technology Town Hospital, Nanjing Medical University, Suzhou 215153, China (LIU Zhen and WANG Xiao-he contributed equally to this paper)
  • Received:2021-03-23 Revised:2021-05-20 Online:2021-09-12 Published:2021-09-12

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摘要： 【摘要】目的探索应用改良No-touch 技术建立兔颈总动脉-颈外静脉内瘘模型的可能性。方法2021 年02 月08 日～02 月22 日，将10 只雄性新西兰兔随机等分为实验组与假手术组。实验组在内瘘手术时不剥离静脉周围组织，即改良No-touch 技术处理颈外静脉，建立颈总动脉-颈外静脉内瘘。假手术组探查到血管后不吻合血管。手术后14d 使用彩色多普勒超声(color doppler ultrasound，CDU)评估内瘘血管内径及血流频谱变化、HE 染色观察动静脉内瘘建立后内膜增生情况，并取兔颈外静脉血行血气分析。结果实验组兔均顺利完成动静脉内瘘手术，成功率100%。手术后14d CDU 评估结果显示实验组兔颈外静脉内径为(7.162±2.332)mm，假手术组兔颈外静脉内径为(2.992±0.277)mm，差异有统计学意义(t=3.582,P=0.016)。实验组兔颈外静脉收缩期峰值流速(peak systolic velocity，PSV) 为(81.480±38.746)cm/s，假手术组兔颈外静脉PSV 为(10.334±1.802)cm/s，差异有统计学意义(t=3.032,P=0.015)。在实验组兔内瘘动脉及流出道静脉观察到“双向血流”频谱，提示血流为螺旋层流。HE染色结果显示，实验组兔颈外静脉内弹力膜破坏、内膜厚度为(26.360±3.769)μm，假手术组兔颈外静脉内膜厚度为(10.239±2.960)μm，差异具有统计学意义(t=-9.516,P＜0.001)。实验组兔颈外静脉血氧分压(PO2)为(78.800±5.890)mmHg(1mmHg=0.133kpa)，假手术组兔颈外静脉血PO2 为(49.000±4.183)mmHg，差异具有统计学意义(t=9.223,P=0.006)。结论应用改良No-touch 技术可成功建立兔颈总动脉-颈外静脉内瘘，成功率高，重复性好，为进一步研究改良No-touch 技术在动静脉内瘘手术中的应用提供理想的动物模型。

关键词: 兔, 动静脉内瘘, 改良No-touch技术, 动物模型

Abstract: 【Abstract】Objective To explore the construct of common carotid artery-external jugular vein arteriovenous fistulas in rabbit model using the modified no-touch technique. Methods Ten male New Zealand rabbits were randomly divided into experimental group and sham operation group. Common carotid artery-external jugular vein arteriovenous fistula was created in experimental group by the modified no-touch technique, the perivenous vascular tissue was not stripped off in the operation. The vessels were not anastomosed in sham operation group. After the operation for 14 days, color Doppler ultrasonography was used to evaluate
the inner diameter change of the arteriovenous fistula and the spectrum of blood flow in it, blood gas was analyzed in the external jugular vein, and the intimal thickness was observed by hematoxylin-eosin staining of the vessel slides. Results The common carotid artery-external jugular vein arteriovenous fistula was successfully constructed in all rabbits in experiment group. After the operation for 14 days, color Doppler ultrasonography found that the inner diameter of external jugular vein was 7.162±2.332 mm in experimental group and was 2.992±0.277 mm in sham operation group (t=3.582, P=0.016), the peak systolic velocity (PSV) in the external jugular vein was 81.480±38.746 cm/s in experimental group and was 10.334±1.802 cm/s in sham operation group (t=3.032, P=0.015), and the bidirectional blood-flow spectrum suggesting spiral laminar flow was observed in the common carotid artery and external jugular vein in experimental group. H-E staining of the vessels showed that the internal elastic membrane of the external jugular vein was destroyed in experimental group, and the intimal thickness was 26.360±3.769 μm in experimental group and was 10.239±2.960 μm in sham operation group (t=−9.516, P<0.001). The partial pressure of oxygen (PO2) in the external jugular vein was 78.800 ± 5.890 mmHg in experimental group, and was 49.000 ± 4.183 mmHg in sham group (t=9.223,
P=0.006). Conclusion The common carotid artery- external jugular vein arteriovenous fistula can be constructed by the modified no-touch technique with a high success rate and an excellent repeatability in rabbit model. This study provides an ideal animal model for the application of modified no-touch technique in arteriovenous fistula surgery.

Key words: Rabbit, Arteriovenous fistula, Modified no-touch technique, Animal model

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