Uehara Shohei, Sasaki Fumisato, Sahara Hisashi, Tanaka Akihito, Hinokuchi Makoto, Maeda Hidehito, Arima Shiho, Hashimoto Shinichi, Kanmura Shuji, Ido Akio
Digestive and Lifestyle Diseases Kagoshima University Graduate School of Medical and Dental Sciences Kagoshima Japan.
Division of Experimental Large Animal Research Life Science and Laboratory Animal Research Unit Center for Advanced Science Research and Promotion Kagoshima University Kagoshima Japan.
DEN Open. 2024 Jul 23;5(1):e411. doi: 10.1002/deo2.411. eCollection 2025 Apr.
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.
Activated coagulation time (ACT) was measured using blood samples drawn from a catheter inserted into the external jugular vein of swine ( = 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 ( = 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.
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 ( = 3), no prolonged ACT or delayed bleeding was observed at 24 h.
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.
尽管内镜手术后延迟出血已成为一个问题，但目前尚无合适的动物模型来验证预防延迟出血的方法。本研究旨在建立一种胃肠道内镜手术后延迟出血的动物模型。
在全身麻醉下，采用切开法从插入猪（n = 7；年龄，6个月；平均体重，13.8 kg）颈外静脉的导管中抽取血样，测量活化凝血时间（ACT）。经口插入上消化道内镜，使用结扎装置通过内镜黏膜切除术在胃内制造12个黏膜缺损。此时确认止血情况。肝素组（n = 4）通过导管接受50单位/千克的普通肝素；在确认10分钟后ACT≥200秒后，开始持续输注肝素（50单位/千克/小时）。24小时后，在全身麻醉下插入内镜，评估胃内的出血量以及黏膜缺损部位的血液附着程度。
肝素治疗组中有3只猪（75%）出现延迟出血，这些猪在开始持续输注肝素前ACT最大值>220秒。在未治疗组（n = 3）中，24小时时未观察到ACT延长或延迟出血。
使用单剂量肝素并在确认ACT为220秒后持续输注肝素，建立了一种胃肠道内镜手术后延迟出血的动物模型。
