文章摘要
沃 琪,任 咪,李 蕾,黄 勇,方 旭,徐军明,张金彦.大鼠肝移植肝上下腔静脉不同缝合方式及手术体会[J].,2021,(4):609-613
大鼠肝移植肝上下腔静脉不同缝合方式及手术体会
Different Suture Technique of Suprahepatic Vena Cava and Corresponding Surgical Experience in Rat Liver Transplantation
投稿时间:2020-06-28  修订日期:2020-07-23
DOI:10.13241/j.cnki.pmb.2021.04.002
中文关键词: 肝上下腔静脉吻合  肝移植  大鼠  异常解剖
英文关键词: Suprahepatic vena cava ananstomosis  Liver transplantation  Rats  Abnormal anatomy
基金项目:国家自然科学基金面上项目(81670595);上海市科委基金项目(15411967200)
作者单位E-mail
沃 琪 上海交通大学附属上海市第一人民医院普外科 上海 200080 woqi0506@163.com 
任 咪 上海交通大学附属上海市第一人民医院普外科 上海 200080  
李 蕾 上海交通大学附属上海市第一人民医院普外科 上海 200080  
黄 勇 复旦大学附属中山医院麻醉科 上海 200030  
方 旭 同济大学附属上海市杨浦区中心医院普外科 上海 200082  
徐军明 上海交通大学附属上海市第一人民医院普外科 上海 200080  
张金彦 上海交通大学附属上海市第一人民医院普外科 上海 200080  
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中文摘要:
      摘要 目的:探讨肝上下腔静脉不同缝合方式对大鼠原位肝移植的影响。方法:选取雄性SD大鼠60对,以SD大鼠为供体和受体,随机分成A、B两组,每组30对。两组均采用改良Kamada "二袖套法"进行大鼠原位肝移植,A组采用双定点连续缝合方式吻合肝上下腔静脉,B组采用单定点连续缝合方式吻合。比较两组肝上下腔静脉吻合时长、无肝期时长以及术后并发症及存活率等情况。结果:A组供体取肝、修肝、无肝期、肝上下腔静脉(SHVC)吻合时长分别为28.5(27.0-31.1) min、9.5(9.0-10.6) min、20.6±1.3 min、8.5(8.0-9.0) min,B组分别为30.0(27.8-32.0) min、9.0(8.6-10.0) min、18.1±1.4 min、7.0(6.5-7.4) min,其中两组的无肝期、SHVC吻合时长具有统计学差异(P<0.05)。A组SHVC吻合口出血4/30例、其他并发症6/30例,B组吻合口出血1/30例、其他并发症5/30例,术后2天以及术后2周存活率以及术后并发症方面,两组均无显著差异(P>0.05)。结论:单定点连续缝合SHVC比双定点连续缝合更有效地缩短无肝期时长,并降低开放后吻合口漏血发生几率,两种吻合方式均能成功建立稳定可行的大鼠肝移植模型。
英文摘要:
      ABSTRACT Objective: To investigate the effects of different suture technique of suprahepatic vena cava(SHVC)reconstruction on rat orthotopic liver transplantation (ROLT). Methods: Sixty pairs of male SD rats were randomly selected as donors and recipients. According to the random number table, the rats were equally divided into group A and group B. The modified Kamada "two-cuff " technique was used to ROLT for the both two groups. In group A, double-point running suture was taken to anastomose SHVC, while single-point running suture was adopted in group B. The SHVC reconstruction time, anhepatic time, postoperative complications and survival were compared between the two groups. Results: The donors' operation time (DOT), cuffing time (CT), anhepatic phase (AP), SHVC reconstruction time (SHVCRT) in group A were respectively 28.5(27.0-31.1) min, 9.5(9.0-10.6) min, 20.6±1.3 min, 8.5 (8.0-9.0) min, and the data in group B were respectively 30.0(27.8-32.0) min, 9.0 (8.6-10.0) min, 18.1±1.4 min, 7.0 (6.5-7.4) min. There were statistical differences on AH and SHVCRT between the two groups (P<0.05). Anastomotic hemorrhage (AH) of SHVC in group A was 4/30 cases, and other complications were 6/30 cases, Of which in group B were respectively 1/30 cases and 5/30 cases(P>0.05). There were no significant differences in two-day and two-week survival rate and postoperative complications between the two groups (P>0.05). Conclusion: The single-point running suture could apparently shorten the anhepatic phase and reduce the incidence of anastomotic hemorrhage, and both anastomosis technique are proved to be reliable and feasible on ROLT.
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