摘要
目的评价经隐动脉入路置管行兔肝肾动脉介入治疗的可行性,与经股动脉入路比较,探讨其替代股动脉入路的可行性。方法 VX2肝肾肿瘤荷瘤大白兔24只,随机分为经股动脉置管组(n=8)和经隐动脉置管组(n=16)。观察隐动脉体表分布及变异;分离动脉,22 G套管针穿刺血管,置入0.018英寸微导丝及5 F微穿鞘管,连接Y阀完成鞘管置入;DSA测量隐动脉、股动脉及髂动脉直径。比较两组游离血管耗时、留置鞘管耗时、鞘管置入深度、置管成功率以及切口感染率、跛行发生率。结果 91.67%(22/24)兔体表可明显观察到隐动脉。两组均成功置入鞘管。隐动脉组与股动脉组比较,游离血管耗时、鞘管置入深度、切口感染率、术后7 d和14 d跛行发生率分别为(367.30±37.30)s对(978.20±156.30)s、(20.20±2.60)mm对(58.60±9.50)mm、0%对37.50%、6.25%对62.50%、0%对25%,差异均有统计学意义(P<0.05);留置鞘管耗时、术后1 d跛行发生率分别为(42.80±9.90)s对(43.60±7.0)s、70%对100%,差异均无统计学意义(P>0.05)。隐动脉、股浅动脉、股总动脉、髂外动脉、髂总动脉直径分别为(1.29±0.12)mm、(1.91±0.27)mm、(2.18±0.15)mm、(2.22±0.13)mm、(2.39±0.15)mm。结论兔隐动脉位置表浅,变异率低,管径可置入5 F微穿鞘管;经其置管便捷省时、创伤小、并发症低,可取代股动脉作为兔肝肾动脉介入治疗的首选置管路径。
Objective To evaluate the feasibility of interventional catheterization via saphenous artery route in treating hepatic and renal lesions, to compare its advantages and disadvantages with trans- femoral approach catheterization, and to discuss the feasibility of using saphenous artery route to replace femoral artery approach. Methods A total of 24 rabbits bearing VX2 liver and kidney tumor were randomly divided into via femoral artery catheterization group（control group,n =8） and via saphenous artery catheterization group（study group,n =16）. Surface distribution and variation of saphenous artery were recorded. After the saphenous artery was isolated, blood vessel was punctured with a 22 G needle, through which a 0.018 inch micro guide wire together with a 5- F micro catheter sheath was inserted into the artery, then, a Y- valve was connected to the sheath. DSA was performed to determine the diameters of the saphenous artery, femoral artery and iliac artery. The used time for isolating the artery and indwelling the sheath, the depth of sheath insertion, the success rate of catheterization, the incision infection rate and the occurrence of claudication in both groups were recorded, and the results were compared. Results Saphenous artery could be clearly observed on body surface in 91.67% of rabbits（22/24）. Successful insertion of catheter sheath was achieved in all rabbits of both groups. The used time of isolating artery, the depth of sheath insertion, the incision infection rate and the occurrence of claudication at 7 and 14 days after the treatment in the study group were（367.30±37.30） seconds,（20.20±2.60） mm, 0%, 6.25% and 0% respectively, while those in the control group were（978.20±156.30） seconds,（58.60±9.50） mm, 37.50%, 62.50% and 25% respectively. The differences in above mentioned measurement items between the two groups were statistically significant（P 0.05）. The used time of indwelling the sheath and the occurrence of claudication at one day after the treatment in the study group and in the control group were（42.80 ±9.90） seconds, 70% and（43.60 ±7.0） seconds, 100%respectively, and no statistically significant differences existed between the two groups（P 0.05）. The diameters of the saphenous artery, superficial femoral artery, common femoral artery, external iliac artery and common iliac artery were（1.29±0.12） mm,（1.91±0.27） mm,（2.18±0.15） mm,（2.22±0.13） mm and（2.39±0.15） mm respectively. Conclusion In rabbits, the saphenous artery is usually superficially located, its anatomical variation rate is very low, and its internal diameter can match 5- F micro catheter sheath.Catheterization via saphenous artery is convenient, time- saving with less damage and fewer complications.Therefore, in treating hepatic and renal lesions in rabbits the catheterization via saphenous artery can be used as the technique of first choice to replace the femoral approach catheterization.
出处
《介入放射学杂志》
CSCD
北大核心
2015年第12期1090-1094,共5页
Journal of Interventional Radiology
关键词
兔
隐动脉
放射学
介入性
动物实验
rabbit
saphenous artery
radiology
interventional
animal experiment
