| 李善宝,李 蕾,宋方彬,岑 瑾,方 旭,徐军明.单人直视下改良建立大鼠原位肝移植模型的体会[J].,2018,(14):2601-2605 |
| 单人直视下改良建立大鼠原位肝移植模型的体会 |
| An Improved Method to Establish Rat Orthotopic Liver Transplantation Model under Single Operator Direct Vision |
| 投稿时间：2018-01-31 修订日期：2018-03-11 |
| DOI：10.13241/j.cnki.pmb.2018.14.001 |
| 中文关键词: 肝移植 大鼠肝移植 无肝期 移植模型 |
| 英文关键词: Liver Transplantation Rat liver transplantation Anhepatic phase Transplantation model |
| 基金项目:上海市科委科研计划项目（15411962700）；国家自然科学基金面上项目（81670595） |
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| 中文摘要: |
| 摘要 目的：建立稳定大鼠原位肝移植模型，缩短术中无肝期时间，提高手术成功率及受体存活率。方法：在Kamada "二袖套法" 的基础上改进，单人直视下建立大鼠原位肝移植模型，行60例SD大鼠原位肝移植手术。本研究简化供受体麻醉方式，供肝采用经门静脉（必要时配合腹主动脉补救方式）进行冷灌注，缩短修肝时间，提前预置牵引线，固定进针位置，改进植入肝脏肝上下腔静脉吻合、肝下下腔静脉及门静脉套管。观察并记录各组大鼠供体手术、修肝套管、无肝期、受体手术及肝移植手术总时间。术后检测1，7，30天受体大鼠肝功能（血清丙氨酸转氨酶（ALT），天冬氨酸转氨酶（AST）及总胆红素（TB））并分析生存情况。结果：无肝期结束后，供体肝脏灌注良好，受体麻醉移除后较快苏醒。供体手术、修肝套管、无肝期、受体手术及肝移植手术总时间分别为（32.5±1.58）、（7.3±1.43）、（15.6±2.62）、（53.2±3.74）、（108.5±2.34）min。大鼠术后24 h（手术成功率）为95 %，1周生存率分别为90 ％，1月生存率分别为86.7 ％。大鼠术后短时间内肝功能水平增高，24 h时ALT（228.5±54.5 IU/L），AST（439.3±86.3 IU/L），TB（6.2±0.7 μM），1周后逐渐恢复正常。结论：改良后的方法可以简易麻醉流程，缩短无肝期，提高手术成功率及受体的生存率。 |
| 英文摘要: |
| ABSTRACT Objective: To establish a stable rat orthotopic liver transplantation model, reduce the time of anhepatic phase, improve the operation success and receptor survival rate. Methods: We make improvement of the Kamada's "two cuff method", the rat orthotopic liver transplantation model was established under the direct vision of single operator, and 60 cases were performed in the SD rats. We simplified the method of anesthesia for the donor and recipient, the donor liver was subjected to cold perfusion via the portal vein (if nec- essary with the abdominal aorta), reduced the donor liver repair time, an improved anastomosis of the suprahepatic and inferior vena cava was performed, the inferior hepatic vena cava and portal vein were cannulated by improving technique. Observe and record the time of donor surgery, mend liver and cannula, anhepatic phase, recipient surgery and the total time of liver transplantation. Liver function of re- cipient rats (including serum alanine aminotransferase (ALT), aspartate aminotransferase (AST) and total bilirubin (TB) ) at 1, 7, and 30 days were detected and analyzed, their survival was also analyzed. Results: When the anhepatic period was over, the donor liver perfu- sion was perfused well and the receptor recovered quickly after the anesthesia removed. The time of donor operation, liver repair cannula, anhepatic phase, recipient operation and total time of liver transplantation were (32.5±1.58), (7.3±1.43), (15.6±2.62), (53.2±3.74), and (108.5±2.34) min respectively. After operation, the success rate of operation was 95 %, the one-week survival rate was 90 %, and the one-month survival rate was 86.7 %. The level of liver function increased in a short time after operation, at 24h after operation the ALT/AST/TB in serum were detected and the values were (228.5±54.5 IU/L) / (439.3±86.3 IU/L) / (6.2±0.7 μM), then the liver func- tion gradually returned to normal after one week. Conclusion: The modified method could simplify the anesthesia progress, shorten the period of anhepatic, improve the success rate of the operation and the survival rate of the receptor. |
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