摘要
目的 :观察医用活性碳微粒灌注肠系膜下动脉的作用效果 ,探讨行结肠癌微栓塞化疗的可能性。方法 :成年杂种犬 19只 ,分为 :①对照组 (A组 ,n =7) ,栓子为直径 (Ф) 30～ 6 0 μm的医用活性碳 (CH4 4)微粒。②单纯微栓塞组(B组 ,n =6 ) ,栓子为Ф10～ 2 0 μm的CH4 4微粒。③微栓塞化疗组 (C组 ,n =6 ) ,栓子为Ф10～ 2 0 μm的CH4 4微粒加化疗药物 (FEM)。行犬肠系膜下动脉插管 ,推注不同栓子 ,观察左半结肠和血管造影状况以及术后反应。于不同时间取组织标本 ,作光镜及透射电镜检查。结果 :推注栓子后 ,A组乙状结肠立即痉挛、苍白 ,约 30min后肠管松弛 ,刺激无反应。DSA显示动脉影僵硬迂曲、分支短少 ,肠系膜下静脉显影长达 30min以上。组织切片见栓塞段结肠壁全层彻底坏死。B、C组乙状结肠亦立即痉挛、苍白 ,但 3～ 5min后缓解 ,肠蠕动恢复。DSA显示血管痉挛较A组轻 ,但较推单纯造影剂重 ,血管显影时间分别为 930s± 192s,6 .2 5s± 1.5 2s ,(P <0 .0 1)。肠系膜下静脉显影达10min左右。犬术后一般反应及组织切片中结肠黏膜及黏膜下层细胞变性、微小灶状坏死 ,C组均较B组强。 2周后恢复正常。淋巴结、肝、肺、肾等组织中见碳栓存在。结论 :结肠可耐受一定程度的微栓塞化疗。该方法有望成为提高结肠癌?
Objective: To investigate the efficacy of IMA infusion of the medical activated carbon(CH 44 ) microspheres to the colon and probe the feasibility of microchemoembolization therapy in colon carcinoma.Methods: Nineteen dogs were randomly divided into three groups. ①In the control group (group A, n=7): CH 44 diameter 30～60μm. ②In the simple microembolization group (group B, n=6): CH 44 diameter 10～20μm. ③In microchemoembolizaton group (group C, n=6):CH 44 diameter 10～20μm +FEM were used. The dogs' IMA were catheterized and then drugs infused through the catheter. Angiography was performed. Tissues of different organs were collected for light and transmission electron microscopic examination. Autopsy was conducted on all the animals in the end. Results: In group A the sigmoid colon was spasmodic and pale as soon as infusion was performed . 30 minutes later, it was paralyzed and perished and perforation occurred. DSA showed vessels spasm very strongly and the shaving time was about 30 minutes. All the dogs died of the colon necrosis. In group B, C, the sigmoid colon spasm and paleness were slight. Vascular showing time was 930±192 seconds under DSA. The branches of vessels became narrower and shorter. The showing time of simple contrast medium was 6.25±1.50 seconds(P<0.01). The ischemia of tissues, cell degeneration and small focal necrosis existed mainly in the mucous and submucous layers. They were reversible and reparable. Damage was stronger in group C than in group B. Extensive colon necrosis and perforation did not occur. Abdominal lymph nodes were blackened. In such organs as the liver, lungs, kidneys and colon far away from the embolized parts, CH 44 microspheres were found. Conclusions: The colon can tolerate the microchemoembolization therapy of CH 44 , diameter 10～20μm, which may improve the treatment of colon carcinoma.
出处
《外科理论与实践》
2002年第1期40-42,共3页
Journal of Surgery Concepts & Practice
