不同固定方式对兔肝动脉介入插管的影响

【摘要】　目的?探讨两种不同固定方式对兔肝动脉插管技术难度的影响。方法?30只新西兰大白兔固定于自制木质平板手术台上行CT增强扫描，获取动脉期腹腔干和腹主动脉信息，CT多曲面重建获取腹腔干及其下层面腹主动脉间夹角；采用改良固定方式固定30只实验兔并获取腹腔干和腹主动脉间夹角。比较两种固定方式下兔腹腔干和腹主动脉夹角的差异。将30只实验兔随机分为实验组与对照组，实验组以改良固定方式固定兔，行股动脉穿刺肝动脉插管，对照组兔固定于木质平板手术台行肝动脉插管，获取并比较两组实验兔手术成功率、手术操作时间及手术并发症发生率。结果?平板固定方式下腹腔干和腹主动脉间夹角为117.93°±13.42°，改良固定方式下夹角为144.40°±14.76°（P＜0.05）；对照组肝动脉插管手术成功率为66.7%（10/15），实验组为100%（15/15）（P＜0.05）；对照组血管夹层发生率为26.7%（4/15），实验组为0%（P＜0.05）；对照组平均手术操作时间为（504.40±47.25） s，实验组为（88.87±14.99） s（P＜0.05）。结论?改良固定方式可改变兔腹腔干和腹主动脉夹角，有效降低肝动脉插管的技术难度，降低并发症发生率，缩短手术时间，提高操作成功率。

The effect of two different fixation methods on the interventional catheterization of hepatic artery in rabbits

Objective To discuss the effect of two different fixation methods on the interventional catheterization of hepatic artery in rabbits.Methods Thirty New Zealand white rabbits were used for this study.The rabbit was fixed on the self-made wooden flat operating-table to receive contrast-enhanced CT scanning.Arterial phase imaging information of celiac trunk and abdominal aortic was obtained.By using multiple curved-planar reconstruction technique,the angle between the celiac trunk and its lower-level abdominal aorta was obtained.Then,the experimental rabbits were fixed with an improved fixation method,which was performed by placing a support between the rabbit back and the operating-table,this support was created by 3D printing technology.The difference in the measured angle between celiac trunk and its lower-level abdominal aorta was compared between the two methods.The 30 New Zealand white rabbits were randomly and equally divided into study group(using improved fixation method)and control group(using self-made wooden flat operating-table),and femoral artery puncture with subsequent hepatic artery catheterization was carried out for all rabbits.The technical success rate,the time spent for operation and incidence of surgical complications in both groups were recorded.Results In the control group and the study group,the mean angle between celiac trunk and its lower-level abdominal aorta was(117.93±13.42)°and(144.40±14.76)°respectively(P<0.05),the technical success rate was 66.7%(10/15)and 100%(15/15)respectively(P<0.05),the occurrence rate of vascular dissection was 26.7%(4/15)and 0%(0/15)respectively(P<0.05),and the average time spent for operation was(504.40±47.25)s and(88.87±14.99)s respectively(P<0.05).Conclusion In performing interventional catheterization of hepatic artery in rabbits,the improved fixation method can change the angle between the celiac trunk and its lower-level abdominal aorta,which can effectively reduce the technical difficulty for selective catheterization,thus,the incidence of complications can be reduced,the time spent for operation can be shortened,and the technical success rate can be improved.