PDF(Pubmed)
Abstract：
UNASSIGNED: Although delayed bleeding after endoscopic procedures has become a problem, currently, there are no appropriate animal models to validate methods for preventing it. This study aimed to establish an animal model of delayed bleeding after endoscopic procedures of the gastrointestinal tract.
UNASSIGNED: Activated coagulation time (ACT) was measured using blood samples drawn from a catheter inserted into the external jugular vein of swine (n = 7; age, 6 months; mean weight, 13.8 kg) under general anesthesia using the cut-down method. An upper gastrointestinal endoscope was inserted orally, and 12 mucosal defects were created in the stomach by endoscopic mucosal resection using a ligating device. Hemostasis was confirmed at this time point. The heparin group (n = 4) received 50 units/kg of unfractionated heparin via a catheter; after confirming that the ACT was ≥200 s 10 min later, continuous heparin administration (50 units/kg/h) was started. After 24 h, an endoscope was inserted under general anesthesia to evaluate the blood volume in the stomach and the degree of blood adherence at the site of the mucosal defect.
UNASSIGNED: Delayed bleeding was observed in three swine (75%) in the heparin-treated group, who had a maximum ACT of >220 s before the start of continuous heparin administration. In the non-treated group (n = 3), no prolonged ACT or delayed bleeding was observed at 24 h.
UNASSIGNED: An animal model of delayed bleeding after an endoscopic procedure in the gastrointestinal tract was established using a single dose of heparin and continuous heparin administration after confirming an ACT of 220 s.
UNASSIGNED: Activated coagulation time (ACT) was measured using blood samples drawn from a catheter inserted into the external jugular vein of swine (n = 7; age, 6 months; mean weight, 13.8 kg) under general anesthesia using the cut-down method. An upper gastrointestinal endoscope was inserted orally, and 12 mucosal defects were created in the stomach by endoscopic mucosal resection using a ligating device. Hemostasis was confirmed at this time point. The heparin group (n = 4) received 50 units/kg of unfractionated heparin via a catheter; after confirming that the ACT was ≥200 s 10 min later, continuous heparin administration (50 units/kg/h) was started. After 24 h, an endoscope was inserted under general anesthesia to evaluate the blood volume in the stomach and the degree of blood adherence at the site of the mucosal defect.
UNASSIGNED: Delayed bleeding was observed in three swine (75%) in the heparin-treated group, who had a maximum ACT of >220 s before the start of continuous heparin administration. In the non-treated group (n = 3), no prolonged ACT or delayed bleeding was observed at 24 h.
UNASSIGNED: An animal model of delayed bleeding after an endoscopic procedure in the gastrointestinal tract was established using a single dose of heparin and continuous heparin administration after confirming an ACT of 220 s.
摘要：
■尽管内窥镜手术后延迟出血已成为一个问题，目前,没有适当的动物模型来验证预防它的方法。本研究旨在建立胃肠道内镜术后迟发性出血的动物模型。
■使用从插入猪颈外静脉的导管中抽取的血液样本测量激活凝血时间（ACT）（n=7；年龄，6个月；平均体重，13.8kg）在全身麻醉下使用切下法。经口插入上消化道内窥镜,通过使用结扎装置进行内窥镜粘膜切除术，在胃中产生了12个粘膜缺损。在该时间点确认止血。肝素组（n=4）通过导管接受50单位/kg的普通肝素；在确认ACT≥200s10分钟后，开始连续肝素给药(50单位/kg/h)。24小时后，在全身麻醉下插入内窥镜以评估胃中的血容量和粘膜缺损部位的血液粘附程度.
■在肝素治疗组中观察到三只猪（75％）的延迟出血，开始连续肝素给药前的最大ACT>220s。在非治疗组（n=3）中，24h时未观察到长期ACT或延迟出血。
■在确认ACT为220s后，使用单剂量肝素和连续肝素给药，建立了胃肠道内镜手术后延迟出血的动物模型。
■使用从插入猪颈外静脉的导管中抽取的血液样本测量激活凝血时间（ACT）（n=7；年龄，6个月；平均体重，13.8kg）在全身麻醉下使用切下法。经口插入上消化道内窥镜,通过使用结扎装置进行内窥镜粘膜切除术，在胃中产生了12个粘膜缺损。在该时间点确认止血。肝素组（n=4）通过导管接受50单位/kg的普通肝素；在确认ACT≥200s10分钟后，开始连续肝素给药(50单位/kg/h)。24小时后，在全身麻醉下插入内窥镜以评估胃中的血容量和粘膜缺损部位的血液粘附程度.
■在肝素治疗组中观察到三只猪（75％）的延迟出血，开始连续肝素给药前的最大ACT>220s。在非治疗组（n=3）中，24h时未观察到长期ACT或延迟出血。
■在确认ACT为220s后，使用单剂量肝素和连续肝素给药，建立了胃肠道内镜手术后延迟出血的动物模型。
