家兔PICC静脉化疗动物模型血管病理变化研究

目的 探讨经外周置入中心静脉导管(PICC)化疗药物对置管静脉的损伤及病理变化,为化疗性静脉损伤发病机制研究和有效的防护方案提供可靠的实验依据.方法 将48只实验兔按随机数字表法分为第1天组(对照),实验组分为:第2、3、7、14、21、23天和24天,成功建立PICC实验兔模型;于置管后第2天和第23天各注射1次酒石...

Study on Vascular Pathological Changes in PICC Intravenous Chemotherapy Animal Model in Rabbits

Abstract: Objective To explore the damage and pathological changes of peripherally inserted central catheter ( PICC) chemotherapeutic drugs to catheterized vein, and to provide reliable experimental basis for the study of the pathogenesis of chemotherapeutic vein injury and the effective prevention plan. Method Forty-eight laboratory rabbits were divided into 8 groups according to the random number table method : day 1 ( the control group) , day 2, day 3, day 7, day 14, day 21, day 23 and day 24. Successfully established in the PICC laboratory rabbit model, vinorelbine injection ( dose 25 mg / m2) was injected once on the day 2 and day 23 after the catheterization, and blood samples were taken at the above 8 time points to test the coagulation indexes and immune indexes. To observe and compare the venous injury in different parts of the 8 groups of laboratory rabbits under light microscope, as well as the dynamic changes of CRP, E-Selectin, P-Selectin, IL-2, IL-6, PLT, PT, D-dimer and other indicators. Result The auricular vein catheterization and the use of chemotherapy drugs showed scar formation on day 1 ( the control group) , a small amount of thrombosis on day 2 ( first injection of vinorelbine) , no thrombosis on day 3, scar formation on day 7 and there was a small amount of thrombosis on day 14, no scar and no thrombosis on day 21, scar formation on day 23 ( reinjection of vinorelbine) , and no scar and no thrombosis on day 24. The anterior vena cava was continuously infiltrated with inflammatory cells of varying degrees. CRP, Eselectin, P-selectin, IL-6 values increased, IL-2 decreased, PLT decreased, PT shortened and D-dimer prolonged. With the extension of chemotherapy interval, venous thrombosis and phlebitis improved significantly. There was significant difference between the control group and the other seven groups ( P < 0. 01) . ConclusionPhlebitis occurred within 24 hours of PICC catheterization. Vascular injury and venous thrombosis were aggravated after the injection of vinorelbine injection. However, the damaged blood vessels were obviously improved after the intermittent period of chemotherapy.