肺血栓塞栓症に対する術中超音波血栓溶解補助療法

术中超声溶栓辅助治疗肺血栓栓塞

• 批准号: 09671373
• 负责人: 村川 眞司
• 金额: $ 2.37万
• 依托单位: Gifu University
• 依托单位国家: 日本
• 项目类别: Grant-in-Aid for Scientific Research (C)
• 财政年份: 1997
• 资助国家: 日本
• 起止时间: 1997 至 1998
• 项目状态: 已结题
• 来源: https://kaken.nii.ac.jp/grant/KAKENHI-PROJECT-09671373/
• 关键词: 肺血栓塞栓症; 血栓溶解療法; 超音波; CCD顕微鏡; 微小循環

A.まず,肺動脈血栓塞栓モデルを作成した.家兎を全身麻酔に気管切開,挿管,人工呼吸とした後,左開胸,左肺を露出した.右心室より左肺動脈にバルーンカテーテルを挿入し,さらに左肺動脈を剥離し,流量計プローブを装着した.1.当初の計画どおり左肺動脈単純遮断にて肺血流を遮断し血栓が作成されるかを検討した.1時間,3時間,6時間の単純遮断を行い,CCD顕微鏡にて肺末梢循環の変化を観察したが,単純遮断のみでは遮断時,肺組織末梢の血流は完全には消失せず,6時間まで遮断を行っても遮断解除後,末梢の血流は再開した.単純遮断のみでは肺動脈内に血栓を形成することが困難であることが判明した.2.肺動脈内に挿入したバルーンカテーテルにて左下肺動脈を閉塞し,線維素溶解阻害剤薬であるepsilon amino caproic acid (EACA)(150mg/kg)を20分間で投与,その後,15分してトロンビン(150NIH units/kg)を投与した.これにより肺末梢の血流が停止し,血栓が形成されたことがCCD顕微鏡による観察にて確認され,これを肺塞栓モデルとして使用することとした.B.Aの肺動脈閉塞モデルにt-PA(58万単位/kg)を投与した.CCD顕微鏡による観察で血流の再開が起こることを観察した.これにより血栓溶解療法の効果をCCD顕微鏡にて評価可能であることを証明した.C.当初予定した超音波発生装置が我々が使用する0.25から5w/cm^2程度の出力の範囲でのコントロールが困難で、組織の障害が強いことが判明したため,本田電子製の超音波発生装置,1MHz-20W(可変),及び300KHz-20W(可変)を選定,購入した.現在A.B.の実験で得られたモデルを1.コントロール群(生食投与群),2.ウロキナーゼ投与群,3.ウロキナーゼ投与+超音波照射群(1MHz,および300KHz,0.25Wから5W/cm^2連続照射)下の3群にわけ最も血栓溶解が早く,且つ組織障害の少ない条件を検討している.

A. まず, pulmonary artery thromboembolism, pulmonary artery thrombosis, pulmonary artery thromboembolism, pulmonary artery thrombosis, pulmonary artery thromboembolism, general anesthesia, tube incision, intubation, and artificial respiration. After that, the left thoracotomy was opened, and the left lung was exposed. The right ventricle was inserted into the left pulmonary artery, and the left pulmonary artery was inserted. The left pulmonary artery was stripped and the flow meter was installed. 1. The original plan was to completely block the left pulmonary artery. The pulmonary blood flow is blocked and the thrombus is blocked. CCD microscopic examination of the changes in the peripheral circulation of the lungs, simple interruption of blood circulation in the terminal parts of the lung tissue. The blood flow completely disappears, and the 6-hour blockage is blocked. After the blockage is lifted, the peripheral blood flow is reopened. 単Pure It is difficult to block the formation of thrombus in the pulmonary artery and it is difficult to determine the formation of thrombus in the pulmonary artery. 2. Insertion into the pulmonary artery Into the left lower pulmonary artery occlusion of the left lower pulmonary artery, linear vitamin dissolution-impairing agent, epsilon amino caproic acid (EACA)(150mg/kg)を20 minutes after administration, 15 minutes after administration (150NIH units/kg) is administered. The blood flow in the terminal lungs is stopped, and thrombus is formed. The CCD microscopic examination is carried out. Confirm the use of pulmonary artery occlusion pulmonary artery occlusion pulmonary artery occlusion -PA (580,000 pieces/kg) investment The effect of thrombolytic therapy with CCD microscopic examination of the blood flow and the re-opening of blood flow are as follows: CCD microscopic examination It is possible to prove that it is possible. C. The ultrasonic hysterectomy device that was originally planned was used and the level of use was 0.25 and 5w/cm^2. The power of the fan is difficult and the organization is difficult, and the obstacle of the organization is strong and clear, ultrasonic generation device manufactured by Honda Electronics, 1MHz-2 0W (can be changed), and 300KHz-20W (can be changed) are selected and purchased. Now A.B.の実験でgetsられたモデルを1.コントロール group (raw food administration group), 2. ウロキナーゼ administration group, 3. ウロキナーゼ administration + ultrasonic irradiation group (1MHz, および 300KHz, Under 0.25W (or 5W/cm^2 continuous irradiation), the thrombosis of the three groups is the most effective and the thrombolysis is early, and the tissue damage is less and the conditions are better.