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| EnSite-NavX三维标测系统指导下去肾交感神经术的实验研究 |
| 谭洪文1,2△,郭志福1△,陈翔1,马丽萍1,张志钢1,朱玉峰1,白元1,赵仙先1,秦永文1* |
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(1. 第二军医大学长海医院心血管内科, 上海 200433;
2. 贵州省人民医院心内科, 贵阳 550002
△共同第一作者
*通信作者) |
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| 摘要: |
| 目的 探讨EnSite-NavX三维标测系统指导下去肾交感神经术的安全性及有效性。方法 选用健康广西巴马小型猪6只,在EnSite-NavX三维标测系统指导下建立腹主动脉及肾动脉的三维立体模型,然后将心脏电生理射频消融导管送入双侧肾动脉主干,在主干内由远至近心端选取6个点并标记,其中一侧放电消融,对侧不消融作对照。随访6个月,观察建模及并发症情况,采用ELISA法测定双侧肾组织去甲肾上腺素的含量,H-E染色观察消融侧肾交感神经毁损情况。结果 6只小型猪均顺利完成建模及一侧去肾交感神经术,1只术后出现下肢皮下血肿;无肾动脉狭窄、血栓形成及夹层等并发症。消融侧肾组织去甲肾上腺素含量(170.13±52.60) ng/g低于未消融侧(429.86±131.43) ng/g,差异有统计学意义(P<0.05)。消融侧肾交感神经未见完整的神经外膜,轴突减少。结论 EnSite-NavX三维标测系统指导下能清楚建立腹主动脉及肾动脉的三维立体模型,并在NavX导航下,无需透视或肾动脉造影即可完成去肾交感神经术,能安全、有效地去肾交感神经。 |
| 关键词: 去肾交感神经 猪 三维标测系统 建模 |
| DOI：10.16781/j.0258-879x.2016.06.0750 |
| 投稿时间：2015-10-06修订日期：2015-11-28 |
| 基金项目:第二军医大学长海医院"1255"学科建设计划(CH125531700). |
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| EnSite-NavX three-dimensional mapping-guided renal sympathetic denervation: an experimental study |
| TAN Hong-wen1,2△,GUO Zhi-fu1△,CHEN Xiang1,MA Li-ping1,ZHANG Zhi-gang1,ZHU Yu-feng1,BAI Yuan1,ZHAO Xian-xian1,QIN Yong-wen1* |
(1. Department of Cardiovasology, Changhai Hospital, Second Military Medical University, Shanghai 200433, China;
2. Department of Cardiology, Guizhou Provincial People's Hospital, Guiyang 550002, Guizhou, China
△Co-first authors
*Corresponding author) |
| Abstract: |
| Objective To explore the safety and efficacy of the renal sympathetic denervation under the guidance of EnSite-NavX three-dimensional mapping system. Methods A three-dimensional model of abdominal aorta and renal artery was constructed under the guidance of EnSite-NavX three-dimensional mapping in 6 healthy Guangxi Bama mini-pigs. Then a radiofrequency ablation catheter was put into the bilateral main trunks of renal artery and six points were marked within each trunk from far to near the heart. One side of the renal artery was ablated and the other received no ablation serving as control. The mini-pigs were followed up for 6 months after the procedure. The norepinephrine (NE) content in the renal tissues was detected by ELISA. Sympathetic nerve damage in the renal tissue of the ablation side was observed by Haematoxylin-Eosin staining. Results Modeling and unilateral renal sympathetic denervation were successfully performed in the six mini-pigs. Subcutaneous hematoma was formed after operation in one pig. None of the pigs had the complications such as renal artery stenosis, thrombopoiesis, or dissection. The NE content of ablation side was significantly lower than that of the opposite side ([170.13±52.60] ng/g vs [429.86±131.43] ng/g, P<0.05). Haematoxylin-Eosin staining showed broken epineurium and loss of axons in the renal sympathetic nerve of the ablation side. Conclusion A three-dimensional model of abdominal aorta and renal artery can be clearly constructed under the guidance of EnSite-NavX three-dimensional mapping. Renal sympathetic denervation can be achieved safely and effectively without fluoroscopy or renal arteriography under the navigation of NavX. |
| Key words: renal sympathetic denervation pig three-dimensional mapping system modeling |
