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目的 :观察医用活性碳微粒灌注肠系膜下动脉的作用效果 ,探讨行结肠癌微栓塞化疗的可能性。方法 :成年杂种犬 19只 ,分为 :①对照组 (A组 ,n =7) ,栓子为直径 (Ф) 30～ 6 0 μm的医用活性碳 (CH4 4)微粒。②单纯微栓塞组(B组 ,n =6 ) ,栓子为Ф10～ 2 0 μm的CH4 4微粒。③微栓塞化疗组 (C组 ,n =6 ) ,栓子为Ф10～ 2 0 μm的CH4 4微粒加化疗药物 (FEM)。行犬肠系膜下动脉插管 ,推注不同栓子 ,观察左半结肠和血管造影状况以及术后反应。于不同时间取组织标本 ,作光镜及透射电镜检查。结果 :推注栓子后 ,A组乙状结肠立即痉挛、苍白 ,约 30min后肠管松弛 ,刺激无反应。DSA显示动脉影僵硬迂曲、分支短少 ,肠系膜下静脉显影长达 30min以上。组织切片见栓塞段结肠壁全层彻底坏死。B、C组乙状结肠亦立即痉挛、苍白 ,但 3～ 5min后缓解 ,肠蠕动恢复。DSA显示血管痉挛较A组轻 ,但较推单纯造影剂重 ,血管显影时间分别为 930s± 192s,6 .2 5s± 1.5 2s ,(P <0 .0 1)。肠系膜下静脉显影达10min左右。犬术后一般反应及组织切片中结肠黏膜及黏膜下层细胞变性、微小灶状坏死 ,C组均较B组强。 2周后恢复正常。淋巴结、肝、肺、肾等组织中见碳栓存在。结论 :结肠可耐受一定程度的微栓塞化疗。该方法有望成为提高结肠癌?
Objective: To observe the effect of injecting activated carbon particles into the inferior mesenteric artery and to explore the possibility of micro-embolization chemotherapy for colon cancer. Methods: Nineteen adult mongrel dogs were divided into: ① control group (group A, n = 7), and the emboli were microscopic activated carbon (CH4 4) particles with diameter of 30 ~ 60 μm. ② Simple micro-embolization group (group B, n = 6), the emboli were Ф10 ~ 20 μm CH4 4 particles. ③ Micro-embolization chemotherapy group (C group, n = 6), the emboli were Ф10 ~ 20 μm CH4 4 particles plus chemotherapy drugs (FEM). Canine instillation of inferior mesenteric artery, bolus injection of different emboli, observation of the left colon and angiography and postoperative response. Tissue specimens at different times for light and transmission electron microscopy. Results: After bolus injection, the sigmoid colon of group A immediately spasm, pale, about 30min after intestinal relaxation, stimuli no response. DSA showed tortuous tortuous arterial shadow, short branches, the development of the superior mesenteric vein for up to 30min. Tissue sections see the embolic section of the full-thickness necrosis of the colon wall. B, C group sigmoid colon immediately spasm, pale, but after 3 ~ 5min ease, recovery of peristalsis. DSA showed that the vasospasm was lighter than that of the A group, but the time of vessel imaging was 930s ± 192s, 6.52s ± 1.52s, respectively (P <0.01). Mesenteric vein imaging for about 10min. Dogs general reaction and histological sections of colon mucosa and submucosa degeneration, small focal necrosis, C group were stronger than the B group. Returned to normal after 2 weeks. Lymph nodes, liver, lung, kidney and other organizations see carbon plug exists. Conclusion: The colon can tolerate some degree of microembolic chemotherapy. The method is expected to become elevated colon cancer?