摘要
背景:目前小肠移植成功率仍不高,简化血管重建的操作,减少供肠的热缺血时间和受体血管阻断时间是提高手术成功率的关键。目的:在大量前期的基础上,拟建立一种存活率高、手术时间短、稳定实用的大鼠小肠移植模型,同时设计一种灵活可靠的输液系统,用于移植后大鼠营养支持。设计、时间及地点:随机对照动物实验,于2006-08/2007-08在解放军第四军医大学第一附属医院中心实验室完成。材料:选用Wistar大鼠160只,共行小肠移植手术80例次。将80只受体大鼠按随机数字表法分为2组,即单纯小肠移植组和小肠移植加腔静脉置管组,每组40只。方法:简化的异位小肠移植术动脉吻合采用供者带肠系膜上动脉的腹主动脉段两端与受者的腹主动脉袖套吻合,静脉吻合采用供者的门静脉与受者的左肾静脉袖套吻合,即三袖套吻合法,移植小肠的近端结扎、远端造口。小肠移植加腔静脉置管组在小肠移植基础上加行腔静脉置管术,静脉输液系统采用腔静脉置管,用肝素帽、套管针、头皮针制作旋转部分。主要观察指标:记录两组大鼠小肠移植手术各阶段耗时及移植成功率,观察营养支持装置中留置管相关并发症发生情况。结果:①单纯小肠移植组手术耗时(135±24)min,其中动脉吻合用时(5±2)min,静脉吻合用时(2±1)min,移植成功率87.5%。②小肠移植加腔静脉置管组手术耗时(158±27)min,显著长于单纯小肠移植组(P<0.05)。移植成功率85%,未发生置管相关并发症。结论:三袖套血管吻合法可简化大鼠小肠移植手术,缩短手术时间。术中同时建立的营养支持模型应用简单,安全可靠,大鼠能够自由活动,不影响输液用药正常进行,长期应用具有良好的耐受性。
BACKGROUND： At present, the small intestine transplantation fewly succeeds, so the high successful rate required to simplify the techniques of vascular remodeling and reduce the time of hot ischemia in donors, and the time of vessel occlusion in recipients as well.
OBJECTIVE： To establish a simple and stable model of small intestine transplantation in rats with high survival rate and short operating time. At the same time, a kind of active transfusion device used in parenteral nutrition after operation was designed.
DESIGN, TIME AND SETTING： A randomized control animal experiment was performed at the Central Laboratory of the First Affiliated Hospital to the Fourth Military Medical University of Chinese PLA from August 2006 to August 2007.
MATERIALS： A total of 160 Wistar rats were selected to receive small intestine transplantation for 80 sets. Eighty recipient rats were randomly divided into two groups, small intestine transplantation group and small intestine transplantation added catheterization of vena cava group. Each group involved 40 rats.
METHODS： Artery anastomosis was done by employing the cuff anastomosis between a segment of donor abdominal aorta with superior mesenteric artery and recipient abdominal aorta, and venous anastomosis was done by employing the cuff anastomosis between donors portal vein and recipient left renal vein, namely tri-cuff anastomosis. The proximal end of grafted intestine was ligated and ileostomy in distant end was performed. The catheterization of vena cava was carried out through preparing the revolving part of venous transfusion system using heparin cap, trochar and scalp acupuncture.
MAIN OUTCOME MEASURES： The operation time and the success rate of the transplantation were recorded in the two groups; The related complications to the catheterization was also detected.
RESULTS： In the small intestine transplantation group, total operation time was （135± 24） minutes. The average time for arterial anastomosis and venous anastomosis was （5± 2�
出处
《中国组织工程研究与临床康复》
CAS
CSCD
北大核心
2008年第31期6085-6088,共4页
Journal of Clinical Rehabilitative Tissue Engineering Research
