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目的采用三种不同方法进行实验犬房间隔造口,比较其优缺点,选择最实用的方法为进一步造口支架植入实验提供方法学保障。方法共 8 只实验犬,其中 2 只采用透视引导下经股静脉穿刺介入性房间隔造口法(简称介入法),2 只采用外科开胸阻断上下腔静脉直视下房间隔穿刺造口法(外科直视法),4 只采用外科开胸经食管超声引导下非阻断循环下经右房穿刺房间隔造口法(简称非阻断超声引导法),分别建立房间隔造口模型,比较三种造口方法的技术成功率、与操作相关的死亡率、技术的可重复性及稳定性等指标。结果 2只采用介入法的实验犬,一只因造口位置偏移导致造口支架植入右心房耳部,一只术中因房间隔穿刺针定位固定困难而放弃介入法,改为外科直视法造口成功 ;2 只采用外科直视法的实验犬,一只术中因心律失常死亡,一只术后 12h 死于心衰,由介入法改外科直视法的实验犬造口成功,并存活 2 周以上 ;4 只采用非阻断超声引导法的实验犬均造口成功,全部存活至两周以上。结论非阻断超声引导法造口技术难度适中,技术稳定性和可重复性好,对动物创伤小,技术成功率及动物存活率高,是较为理想的实验犬房间隔造口模型的建立方法。
OBJECTIVE To study the atrial septostomy of canine by three different methods and to compare the advantages and disadvantages of them. The most practical method is to provide the methodological guarantee for further stoma implantation experiment. Methods A total of 8 experimental dogs, of which 2 were guided by the fenestration under the guidance of femoral vein puncture method (referred to as interventional method), 2 using surgical thoracotomy blocking the superior vena cava under direct septal puncture stoma (Surgical direct-view method), 4 underwent open thoracotomy esophageal ultrasound-guided non-blocking circulation through the right atrium puncture atrial septostomy (referred to as non-blocking ultrasound guided method), respectively, to establish atrial septostomy model The technical success rates of the three stoma methods, mortality related to the operation, technical repeatability and stability were compared. Results Two dogs were involved in the interventional procedure, one was implanted in the right atrium of the right atrium due to the misalignment of the ostomy. One patient was given a surgical intervention because of the difficulty of positioning and fixing the atrial septal puncture needle. Two cases of experimental dogs undergoing surgical direct vision were killed by arrhythmia. One died of heart failure at 12 hours after operation. The experimental canine stoma was successfully surgically modified by interventional surgery , And survived for more than two weeks. Four experimental dogs with non-blocking ultrasound guided method all succeeded in stoma, all of them survived for more than two weeks. Conclusion The non-blocking ultrasound-guided ostomy technique has the advantages of moderate difficulty, good technical stability and repeatability. It is an ideal method to establish a canine atrial septal model for animal trauma, technical success rate and high animal survival rate .