摘要目的 探讨无放射设备指引下行闭胸家兔右心室插管方法,比较在放射设备指引下经上腔静脉入路和下腔静脉入路行闭胸家兔肺动脉插管的差异.方法 实验动物为新西兰白兔60只,雌雄各半.20只家兔用于解剖学测量,按体质量不同分为轻体质量组(n=10)、重体质量组(n=10)),测量家兔的解剖学数据,并解剖确定右心房体表标志,根据获得的解剖学数据选择导管并进行加工处理.20只家兔用于右心室插管,根据右心房体表标志结合右颈总静脉长度估算插管深度,通过解剖判断插管成功比例.20只家兔按随机数字表分为上腔静脉组(n=10)和下腔静脉组(n=10),在数字减影血管造影设备引导下选用3F微导管分别经上腔静脉、下腔静脉行闭胸家兔肺动脉插管,比较两组插管成功比例.结果 仰卧位时家兔右第二前肋与胸骨连接处为右心房的体表标志.轻体质量组、重体质量组家兔右颈总静脉长度分别为(6.2±0.2)cm、(7.1 ±0.4)cm,右颈总静脉直径分别为(3.7±0.1) mm、(4.1±0.3)mm,三尖瓣直径分别为(3.5±0.2)mm、(4.1±0.3)mm.右心室插管成功比例为80.0％ (16/20).与上腔静脉组比较,下腔静脉组肺动脉插管成功比例显著增高[100.0％ (10/10)比40.0％ (4/10),P＜0.01].结论 成功建立了无放射设备指引下行闭胸家兔右心室插管的方法.经下腔静脉入路行闭胸家兔肺动脉插管优于经上腔静脉入路.

abstractsObjective To explore the method for right ventricle catheterization in close chest rabbit model without guidance of radiative equipments,and to compare the differences between superior and inferior vena caval routes in pulmonary artery catheterization under radiative guidance in close chest rabbit model.Methods The experimental animals were 60 New Zealand rabbits with a 1:1 male to female ratio.Twenty rabbits were used in anatomical measurements.According to body mass,they were divided into light body mass group (n=10) and heavy body mass group (n=10).Anatomical data of these rabbits were measured,and the surface landmarks of the right atrium were determined by dissection.Catheters used for subsequent experiments were selected and modified according to these anatomical data obtained.Another 20rabbits were used for right ventricular catheterization.The depth of catheterization was estimated based on the right atrium landmarks combined with the total length of the right common jugular vein.The rate of successful catheterization was determined by dissection.The remaining 20 rabbits were randomly divided into the superior vena cava group (n=10) and the inferior vena cava group (n=l0).3F miniature catheter was advanced to the pulmonary artery of the close-chest rabbit through superior vena cava or inferior vena cava under guidance with digital subtraction angiography.The rate of successful catheterization was then compared between two groups.Results The body surface landmark of right atrium was located at the junction of the second right rib and the sternum of rabbit in supine position.In the light and heavy body mass groups,the length of the right common jugular vein was (6.2±0.2) cm vs (7.1±0.4) cm; the diameter of this vein,(3.7± 0.1) mm vs (4.1±0.3) mm; the diameter of tricuspid annulus,(3.5±0.2) mm vs (4.1±0.3) mm,accordingly.The successful rate of right ventricle catheterization was 80.0％ (16/20).Compared with superior vena cava route,pulmonary artery catheterization via inferior vena cava yielded significantly higher rate of success [100.0％ (10/10) vs 40.0％ (4/10),P＜0.01].Conclusions A new method for catheterization of right ventricle in close chest rabbits was developed.Compared with the superior vena caval route,catheterization of pulmonary artery in rabbits via inferior vena cava appears more likely to be successful.