本文選題：豬 + 二尖瓣置換��； 參考：《昆明醫(yī)學(xué)院》2011年碩士論文

【摘要】：目的：建立豬二尖瓣置換(MVR)動(dòng)物模型,探討影響該動(dòng)物模型成功建立的關(guān)鍵因素,評(píng)估模型建立的價(jià)值和可操作性。在此基礎(chǔ)上比較不同構(gòu)型人工瓣膜下游血流動(dòng)力學(xué)的優(yōu)劣,為進(jìn)一步研究人工心瓣下游血流動(dòng)力學(xué)與瓣膜及其瓣下結(jié)構(gòu)保留術(shù)式之間的相互關(guān)系提供方法學(xué)基礎(chǔ)。 方法：選擇滇南小耳豬封閉群7頭,采用全麻體外循環(huán)下經(jīng)左心耳入路行保留全瓣瓣下結(jié)構(gòu)的二尖瓣置換術(shù)的方法建立動(dòng)物模型,根據(jù)所替換人工瓣膜類型分為三組：?jiǎn)稳~機(jī)械瓣組(n=2)；雙葉機(jī)械瓣組(n=3)；生物瓣組(n=2)。在模型建立的基礎(chǔ)上通過(guò)與計(jì)算機(jī)圖像分析相結(jié)合的彩色多譜勒超聲技術(shù)評(píng)估手術(shù)前后心臟的結(jié)構(gòu)功能與血流動(dòng)力學(xué)等指標(biāo),并對(duì)不同構(gòu)型人工瓣膜下游湍流剪應(yīng)力進(jìn)行對(duì)比分析。 結(jié)果：各組動(dòng)物模型均順利建立,平均手術(shù)時(shí)間175.0±38.9min,平均轉(zhuǎn)流時(shí)間103.8±17.7min,平均阻斷時(shí)間51.2±17.8min,平均輔助時(shí)間31.2±5.7min,預(yù)充血量555.5±46.3m1,轉(zhuǎn)流中鼻溫平均28.5±1.4℃。常規(guī)血流動(dòng)力學(xué)指標(biāo)比較結(jié)果顯示：手術(shù)前后心率(HR)比較差異有統(tǒng)計(jì)學(xué)意義(P0.05)；手術(shù)前后平均動(dòng)脈壓(MAP),中心靜脈壓(CVP)無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。常規(guī)彩色超聲指標(biāo)比較結(jié)果顯示：手術(shù)前后左室射血分?jǐn)?shù)(LVEF)、左室短軸縮短率(LVFS)、左室舒張末期內(nèi)徑(LVEDD)和左室收縮末期內(nèi)徑(LVESD)無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。血?dú)馍笜?biāo)比較結(jié)果顯示：術(shù)中轉(zhuǎn)流同術(shù)前相比,PH值差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05); PaO2、BE、Hb、K+差異有統(tǒng)計(jì)學(xué)意義(P0.05)；術(shù)后2h同術(shù)前相比：PH值、K+、BE差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05), PaO2、Hb差異有統(tǒng)計(jì)學(xué)意義(P0.05)。心瓣流體力學(xué)指標(biāo)比較結(jié)果顯示：不同構(gòu)型人工瓣膜術(shù)后核心位點(diǎn)湍流剪應(yīng)力(TSS)差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)；邊界位點(diǎn)TSS差異有統(tǒng)計(jì)學(xué)意義(P0.05)。 結(jié)論：本研究建立豬的MVR動(dòng)物模型能真實(shí)客觀地模擬人體MVR的血流動(dòng)力學(xué)狀況,該方法科學(xué)可靠,可行性強(qiáng)。保留全瓣瓣下結(jié)構(gòu)人工心瓣下游TSS的對(duì)比分析顯示：?jiǎn)稳~機(jī)械瓣最大,雙葉機(jī)械瓣次之,生物瓣最��；研究結(jié)果提示：三種不同構(gòu)型人工瓣膜中,其血流動(dòng)力學(xué)性能以生物瓣較佳,單葉機(jī)械瓣較差,雙葉機(jī)械瓣介于兩者之間。從人工瓣膜最小應(yīng)力原則考慮,目前機(jī)械瓣的血流動(dòng)力學(xué)性能有進(jìn)一步改善的必要。
[Abstract]:Objective : To establish an animal model of porcine mitral valve replacement , to discuss the key factors influencing the success of the animal model and to evaluate the value and operability of the model .

Methods : 7 patients were selected from the closed group of small ear pig in southern Yunnan province . The model was established by the method of left atrial appendage valve replacement under cardiopulmonary bypass . The model was divided into three groups according to the type of replacement prosthetic valve : single lobe mechanical valve group ( n = 2 ) ;
Two - leaf mechanical valve group ( n = 3 ) ;
The structure function and hemodynamics of the heart before and after operation were evaluated by the color Doppler ultrasound technique combined with computer image analysis based on the model establishment , and the turbulent shear stress downstream of the artificial valve in different configurations was analyzed .

Results : The average operative time was 175.0 鹵 38.9min , the mean transit time was 103.8 鹵 17.7min , the mean blocking time was 51.2 鹵 17.8min , the mean duration of auxiliary time was 37.2 鹵 5.7min , the pre - filling volume was 555 . 5 鹵 46.3m1 , the mean nasal temperature was 28.5 鹵 1.4 鈩，

本文編號(hào)：1784718