Name: assessment of plasma coagulation on liver tissue in a large animal model in vivo
Uploaded: 2018-08-04T13:00:00
Description: Watch this Scientific Journal Video about Assessment of Plasma Coagulation on Liver Tissue in a Large Animal Model In Vivo at JoVE.com

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遵循德国法律的动物研究法规以及实验动物保育原则 (国立卫生研究院出版版 8, 2011)。官方许可来自政府动物护理办公室 (Landesamt Natur, Umwelt 和 Verbraucherschutz Nordrhein, Westfalen, 德国)。
1. 动物
<ol><li>使用雌性德国长白猪 (重25-30 公斤) 存放在开放的笼子里。</li>
	<li>每组使用5只动物 (氩和氦)。</li>
	<li>允许动物在实验前至少一周适应环境。快速动物为 24 h 在手术之前以自由地获?...

<ol>
	<li>Link, W. J., Incropera, F. P., Glover, J. L. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=A+plasma+scalpel:+comparison+of+tissue+damage+and+wound+healing+with+electrosurgical+and+steel+scalpels.">A plasma scalpel: comparison of tissue damage and wound healing with electrosurgical and steel scalpels.</a> ArchSurg. 111, 392-397 (1976).</li><li>Kwon, A. 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E. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Technology+of+argon+plasma+coagulation+with+particular+regard+to+endoscopic+applications.">Technology of argon plasma coagulation with particular regard to endoscopic applications.</a> EndoscSurgAllied Technol. 2, 71-77 (1994).</li><li>Grund, K. E. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Argon+plasma+coagulation+(APC):+ballyhoo+or+breakthrough?.">Argon plasma coagulation (APC): ballyhoo or breakthrough?.</a> Endoscopy. 29, 196-198 (1997).</li><li>Glowka, T. R., Standop, J., Paschenda, P., Czaplik, M., Kalff, J. C., Tolba, R. 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U., Blum, A., Schlegel, A., Farin, G., Garbe, C. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Application+of+argon+plasma+coagulation+in+skin+surgery.">Application of argon plasma coagulation in skin surgery.</a> Dermatology. 197, 152-157 (1998).</li><li>Carus, T., Rackebrandt, K. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Collateral+tissue+damage+by+several+types+of+coagulation+(monopolar,+bipolar,+cold+plasma+and+ultrasonic)+in+a+minimally+invasive,+perfused+liver+model.">Collateral tissue damage by several types of coagulation (monopolar, bipolar, cold plasma and ultrasonic) in a minimally invasive, perfused liver model.</a> ISRNSurg. , 518924 (2011).</li><li>Bludau, M., Vallbohmer, D., Gutschow, C., Holscher, A. H., Schroder, W. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Quantitative+measurement+of+gastric+mucosal+microcirculation+using+a+combined+laser+Doppler+flowmeter+and+spectrophotometer.">Quantitative measurement of gastric mucosal microcirculation using a combined laser Doppler flowmeter and spectrophotometer.</a> DisEsophagus. , (2008).</li><li>Beckert, S., Witte, M. B., Konigsrainer, A., Coerper, S. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=The+impact+of+the+Micro-Lightguide+O2C+for+the+quantification+of+tissue+ischemia+in+diabetic+foot+ulcers.">The impact of the Micro-Lightguide O2C for the quantification of tissue ischemia in diabetic foot ulcers.</a> Diabetes Care. 27, 2863-2867 (2004).</li><li>Erdogan, D., de Graaf, W., van Gulik, T. M. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Adhesive+strength+of+fibrinogen-coated+collagen+patch+or+liquid+fibrin+sealant+in+an+experimental+liver+resection+model+in+pigs.">Adhesive strength of fibrinogen-coated collagen patch or liquid fibrin sealant in an experimental liver resection model in pigs.</a> Eur Surg Res Eur Chir Forsch Rech Chir Eur. 41 (3), 298-302 (2008).</li><li>Knobloch, K., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Microcirculation+of+the+sternum+following+harvesting+of+the+left+internal+mammary+artery.">Microcirculation of the sternum following harvesting of the left internal mammary artery.</a> ThoracCardiovascSurg. 51, 255-259 (2003).</li><li>Kanzler, S., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Recommendation+for+severity+assessment+following+liver+resection+and+liver+transplantation+in+rats:+Part+I.">Recommendation for severity assessment following liver resection and liver transplantation in rats: Part I.</a> Lab Anim. 50 (6), 459-467 (2016).</li><li>Pehb&#246;ck, D., Dietrich, H., Klima, G., Paal, P., Lindner, K. 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C. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Modified+spectrometry+(O2C+device)+of+intraoperative+microperfusion+predicts+organ+function+after+kidney+transplantation:+a+pilot+study.">Modified spectrometry (O2C device) of intraoperative microperfusion predicts organ function after kidney transplantation: a pilot study.</a> Transplant Proc. 41 (9), 3575-3579 (2009).</li><li>Patterson, E. J., Scudamore, C. H., Owen, D. A., Nagy, A. G., Buczkowski, A. K. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Radiofrequency+ablation+of+porcine+liver+in+vivo:+effects+of+blood+flow+and+treatment+time+on+lesion+size.">Radiofrequency ablation of porcine liver in vivo: effects of blood flow and treatment time on lesion size.</a> AnnSurg. 227, 559-565 (1998).</li></ol>

肝脏手术的啮齿动物模型建立了很长时间16。然而, 大型动物模型提供了一定的优势: 不需要显微外科设备作为人体标准手术设备, 手术技术可与临床使用相媲美, 标准的临床评价方法可以转移到实验。例如, 标准的临床血液测试可以进行, 而不需要特殊的实验室测试方法 (图 10)。
猪是适当的实验动物为心肺研究作为他们的生理相似人<sup c...

氩离子凝固 (APC) 是腹部手术中广泛使用的仪器, 三年来1、2。通过封堵肝切口表面, 防止术后出血3, 是大鼠肝切除术后继发止血的标准技术。等离子凝固是射频烙的一种特殊形式, 通过电离气体电弧传递电能。提供单电热止血, 这种非接触技术具有防止电极黏附在组织4的优势。电离气体光束被自动定向到最低电阻的区域, 当电阻上升时, 由于干燥到其他尚未干燥的区域, 就会被转走。这产生一个统一的有限深度的凝固5,6。影响凝血效果的因素有活化时间、凝固装置的功率设置以及探针与组织的距离。氦是另一种载体气体, 可用于等离子凝固7。最近的临床研究集中在临床结果, 而不是组织学和功能发现3,8,9, 而实验研究集中在体外调查10或实验在分离的被灌注的器官11。
基础协议允许研究在接近于临床应用的大型动物模型中的血浆凝固作用在猪附近使用标准人的设备: 微循环由激光多普勒流量计无创性评估和分光光度计, 这是一个标准的临床工具为这个征兆12,13。凝固过程中的温度变化用红外线温度计和红外相机进行监测。在采集组织样品后, 测定组织学上的苏木素/伊红染色切片的凝固深度。为与其他二次止血方法进行比较, 进行了爆破压力实验。与以前描述的技术14相比, 这些都是在说明器官上进行的, 以排除血压相关的影响。除了所述的对血浆凝固局部效应的研究外, 还可以在猪模型中进行标准血液检测。

<table border="0" cellpadding="0" cellspacing="0" width="824">
	<tbody>
		<tr height="47">
			<td height="47" style="height:47px;width:216px;">Xylazine 20 mg/mL</td>
			<td style="width:184px;">Vetoquinol GmbH</td>
			<td style="width:192px;">Xylapan</td>
			<td style="width:232px;"></td>
		</tr>
		<tr height="47">
			<td height="47" style="height:47px;width:216px;">Ketamine 100 mg/mL</td>
			<td style="width:184px;">Ceva GmbH</td>
			<td style="width:192px;">Ceva Ketamine Injection</td>
			<td style="width:232px;"></td>
		</tr>
		<tr height="47">
			<td height="47" style="height:47px;width:216px;">Atropine 100 mg / 10 mL</td>
			<td style="width:184px;">Dr. Franz K&#246;hler Chemie GmbH</td>
			<td style="width:192px;">Atropinsulfat K&#246;hler 100mg Amp.</td>
			<td style="width:232px;"></td>
		</tr>
		<tr height="47">
			<td height="47" style="height:47px;">Propofol</td>
			<td style="width:184px;">Fresenius Kabi GmbH</td>
			<td style="width:192px;">Propofol 1% MCT Fresenius</td>
			<td style="width:232px;"></td>
		</tr>
		<tr height="47">
			<td height="47" style="height:47px;">Fentanyl</td>
			<td style="width:184px;">KG Rotexmedica GmbH</td>
			<td style="width:192px;">Fentanyl 0,5mg Rotexmedica</td>
			<td style="width:232px;"></td>
		</tr>
		<tr height="47">
			<td height="47" style="height:47px;">Isoflurane</td>
			<td style="width:184px;">Abbot GmbH</td>
			<td style="width:192px;">Forene 100% (V/V) 250 mL</td>
			<td style="width:232px;"></td>
		</tr>
		<tr height="47">
			<td height="47" style="height:47px;">Ringer&#39;s lactate solution</td>
			<td style="width:184px;">Baxter Deutschland GmbH</td>
			<td style="width:192px;"></td>
			<td style="width:232px;">sodium 131mmol/l, potassium 5 mmol/l, calcium 2 mmol/l, cloride 111 mmol/l, lactate 29 mmol/l</td>
		</tr>
		<tr height="47">
			<td height="47" style="height:47px;width:216px;">Surgical disinfactant</td>
			<td style="width:184px;">Sch&#252;lke &#38; Mayr GmbH</td>
			<td style="width:192px;">Kodan Tinktur forte gef&#228;rbt 1l 104804</td>
			<td style="width:232px;"></td>
		</tr>
		<tr height="47">
			<td height="47" style="height:47px;width:216px;">Motorized microscope</td>
			<td style="width:184px;">Nikon Instruments Europe</td>
			<td style="width:192px;">Eclipse TE2000-E</td>
			<td style="width:232px;"></td>
		</tr>
		<tr height="47">
			<td height="47" style="height:47px;width:216px;">Microscope camera</td>
			<td style="width:184px;">Nikon Instruments Europe</td>
			<td style="width:192px;">Digitalsight DS-Qi1Mc</td>
			<td style="width:232px;"></td>
		</tr>
		<tr height="47">
			<td height="47" style="height:47px;width:216px;">Imaging software</td>
			<td style="width:184px;">Nikon Instruments Europe</td>
			<td style="width:192px;">NIS elements Vers. 4.40</td>
			<td style="width:232px;"></td>
		</tr>
		<tr height="47">
			<td height="47" style="height:47px;width:216px;">Plasma coagulator</td>
			<td style="width:184px;">S&#246;ring GmbH</td>
			<td style="width:192px;">CPC-1000</td>
			<td style="width:232px;"></td>
		</tr>
		<tr height="47">
			<td height="47" style="height:47px;width:216px;">Argon gas</td>
			<td style="width:184px;">Linde AG</td>
			<td style="width:192px;">Argon 4.8&#160;</td>
			<td style="width:232px;"></td>
		</tr>
		<tr height="47">
			<td height="47" style="height:47px;width:216px;">Helium gas</td>
			<td style="width:184px;">Linde AG</td>
			<td style="width:192px;">Helium 4.8</td>
			<td style="width:232px;"></td>
		</tr>
		<tr height="47">
			<td height="47" style="height:47px;width:216px;">O2C</td>
			<td style="width:184px;">LEA Medizintechnik GmbH</td>
			<td style="width:192px;">O2C Version 1212</td>
			<td style="width:232px;">with LF-2 or LF-3 probe</td>
		</tr>
		<tr height="47">
			<td height="47" style="height:47px;">Infrared thermometer</td>
			<td style="width:184px;">Voltcraft</td>
			<td>VOLTCRAFT IR 260-8S</td>
			<td style="width:232px;"></td>
		</tr>
		<tr height="47">
			<td height="47" style="height:47px;width:216px;">Thermographic camera</td>
			<td>InfraTec GmbH</td>
			<td>VarioCAM HD head 820</td>
			<td style="width:232px;"></td>
		</tr>
		<tr height="47">
			<td height="47" style="height:47px;width:216px;">Thermographic analysis sofrtware</td>
			<td>InfraTec GmbH</td>
			<td style="width:192px;">IRBIS 3</td>
			<td style="width:232px;"></td>
		</tr>
		<tr height="47">
			<td height="47" style="height:47px;width:216px;">Mayer&#39;s Hematoxylin solution</td>
			<td></td>
			<td style="width:192px;">Merck 1.09249</td>
			<td style="width:232px;"></td>
		</tr>
		<tr height="47">
			<td height="47" style="height:47px;width:216px;">Eosin solution</td>
			<td style="width:184px;">VWR International GmbH</td>
			<td style="width:192px;">Merck 1.09844</td>
			<td style="width:232px;"></td>
		</tr>
		<tr height="47">
			<td height="47" style="height:47px;width:216px;">Rollerpump Masterflex L/S easy Load</td>
			<td style="width:184px;">Cole-Parmer Instrument Company</td>
			<td style="width:192px;">model 7518-10</td>
			<td style="width:232px;"></td>
		</tr>
		<tr height="47">
			<td height="47" style="height:47px;width:216px;">Perfusorpump</td>
			<td style="width:184px;">B. Braun Melsungen AG</td>
			<td style="width:192px;">Perfusor secura FT</td>
			<td style="width:232px;"></td>
		</tr>
		<tr height="47">
			<td height="47" style="height:47px;width:216px;">Digital pressure meter</td>
			<td style="width:184px;">Greisinger electronic</td>
			<td style="width:192px;">GMH 3161</td>
			<td style="width:232px;"></td>
		</tr>
		<tr height="47">
			<td height="47" style="height:47px;width:216px;">Perfusorsyringe, 50 mL</td>
			<td style="width:184px;">B. Braun Melsungen AG</td>
			<td style="width:192px;">REF 8728810 F</td>
			<td style="width:232px;"></td>
		</tr>
		<tr height="47">
			<td height="47" style="height:47px;width:216px;">Perfusor line, Type IV Standard, PVC Luer lock</td>
			<td style="width:184px;">B. Braun Melsungen AG</td>
			<td style="width:192px;">REF 8722960</td>
			<td style="width:232px;"></td>
		</tr>
		<tr height="47">
			<td height="47" style="height:47px;width:216px;">3-Way stopcock, Dicofix C35C</td>
			<td style="width:184px;">B. Braun Melsungen AG</td>
			<td style="width:192px;">REF 16494 C</td>
			<td style="width:232px;"></td>
		</tr>
		<tr height="47">
			<td height="47" style="height:47px;width:216px;">Silk 2-0. 3 metric</td>
			<td style="width:184px;">Resorba</td>
			<td style="width:192px;">REF H5F</td>
			<td style="width:232px;"></td>
		</tr>
		<tr height="47">
			<td height="47" style="height:47px;width:216px;">Vicryl 4-0 Sutupak</td>
			<td style="width:184px;">Ethicon</td>
			<td>V1224H</td>
			<td style="width:232px;"></td>
		</tr>
		<tr height="47">
			<td height="47" style="height:47px;width:216px;">NaCl 0.9 %</td>
			<td style="width:184px;">B. Braun Melsungen AG</td>
			<td style="width:192px;"></td>
			<td style="width:232px;"></td>
		</tr>
	</tbody>
</table>

assessment of plasma coagulation on liver tissue in a large animal model in vivo

血浆凝固作为一种烙的形式, 用于肝脏手术数十年, 以封闭大肝切除术后, 主要切除后, 以防止出血的后期阶段。血浆凝固对肝脏组织的确切的作用只被检查的很少。在我们的猪模型中, 凝血作用可以接近临床应用。联合激光多普勒流量计和分光光度计文件在8毫米组织深度无创性凝血过程中微循环的变化, 提供了超出主观临床印象的可量化的止血信息。在凝固过程中, 用红外线温度计对凝血部位的温度进行评估, 在凝固期间用红外相机测量气体束温度, 因为器件的上阈值是不可能的。用目标测微仪标定后的苏木精/红/红染色切片, 对凝固深度进行了显微测量, 并给出了功率设定-凝固深度关系的准确信息。在胆管上检查密封效果, 因为血浆凝固无法封堵较大的血管。对说明器官进行了爆裂压力实验, 排除了血压的相关影响。

微循环:通过对血浆凝固后止血的诊断装置, 可以通过微循环的改变来证明。毛细管血流 (显示为任意单位 (AU)) 从基线值减少 142.7, 76.08 au 到 57.78, 49.57 au 在 25 w 设备输出功率, 48.5 @ 7.26 au 在 50 w 和 5.04 @ 1.31 au 在 100 w (图 4)。
温度:用红外相机测量凝固部位的温度 (图 ...

Watch this Scientific Journal Video about Assessment of Plasma Coagulation on Liver Tissue in a Large Animal Model In Vivo at JoVE.com

Assessment of Plasma Coagulation on Liver Tissue in a Large Animal Model In Vivo

在这里, 我们提出了一个实验性的评估血浆凝固在体内的肝脏组织的协议。在猪模型中, 通过激光多普勒检查微循环, 用红外测温仪和红外相机对凝血深度进行组织学测量, 凝血部位温度, 并通过爆裂压力记录管道密封效果。实验。

大动物模型肝组织血浆凝固的评价

Plasma coagulation as a form of electrocautery is used in liver surgery for decades to seal the large liver cut surface after major hepatectomy to prevent ...

Research

JoVE Journal

Medicine

Assessment of Plasma Coagulation on Liver Tissue in a Large Animal Model In Vivo

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科研

医学

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