經食管支架植入術反流性食管炎大鼠模型的建立與探討

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1.廣西中醫藥大學第一附屬醫院脾胃病科，廣西 南寧 530023； 2.廣西中醫藥大學研究生學院

【Abstract】ObjectiveTo improve the technique of cardiac steel ring implantation and fixation, and to establish the rat modeling method of reflux esophagitis(RE), and to explore the feasibility and effectiveness of esophageal stent implantation.MethodsThirty SD rats were randomly divided into the model group and control group. The rats in model group were treated by esophageal stent implantation: a steel ring was fixed on a sheath and pushed from the mouth to the cardia through esophagus, and then it was fixed with fish line suturing. The rats in control group were treated by esophageal balloon dilatation: a balloon was inserted along the guide wire into esophagus and localized in the gastroesophageal junction, then the balloon was inflated to maintain 10 minites. After operation, nursing observation and weight measurement were carried out on the animals, and the pathological changes of the esophageal specimens were obtained after 4 weeks.ResultsThe pathological examination showed that both two groups had obvious pathological changes in esophagus. Pathological changes and inflammatory lesions, especially in the lower esophagus, were obviously observed in the esophageal mucosa of the rats. And the pathological changes in the model group were more serious than that in the control group, while, the model group had a low survival rate.ConclusionUsing esophageal stent implantation could successfully produce the rat model of RE, which has the features of significant pathological changes in esophagus, relatively simple operation and light trauma with the rats, showing that the modeling method is feasible and worth popularization.

【Keywords】 Rat model; Reflux esophagitis; Esophageal interventional therapy; Stent implantation

胃食管反流病(gastroesophageal reflux disease，GERD)是胃內容物反流入食管、口腔(包括喉部)或肺所致的癥狀和并發癥。酸(堿)反流導致的食管黏膜破損稱為反流性食管炎(reflux esophagitis，RE)。近年來，隨著國內外對RE發病原因和機制的相關研究不斷深入，RE動物模型的研究成為目前研究的一個熱點。廖旭等應用食管氣囊擴張微創方法建立GERD動物模型，探索食管下括約肌(low esophageal sphincter,LES)松弛發病的機制，然而成功率偏低。王斌等在廖旭的基礎上改用Forley導尿管建立兔RE模型，不足之處為擴張強度較難把握。有學者[5-7]探索破壞LES及其周圍解剖組織的方法造成GERD，采用部分賁門肌切開加幽門半縫扎術制備RE動物模型。有學者[8]探索采用不同幽門管徑限制幽門舒張合并前胃結扎以限制胃容量的方法制作RE模型，探討不同的幽門結扎內徑大小對RE模型的存活率、食管炎發生率的影響。另有學者[9]采用食管十二指腸側側吻合術疊加夾尾刺激法所形成的RE大鼠動物模型制備方法，發現模型質量及病變形成率高，術后動物并發癥及死亡率相對較小。為了探索安全有效的動物模型制備方法，本研究在借鑒以往RE動物模型制作方法的基礎上，擬通過經食管植入金屬支架的技術手段，擴張動物食管下端，來制作RE的大鼠模型。

1 材料與方法

1.1實驗動物12～13月齡清潔級SD大鼠30只，雌雄各半，體質量220～250 g，購自廣西醫科大學實驗動物中心，實驗動物合格證號：SCXK桂2009-0002。實驗動物使用許可證：SYKG桂2009-2005。……