大鼠原位肝移植模型的建立及并发症的预防

目的建立稳定的大鼠原位肝移植模型，探讨如何通过改进手术操作预防术中和术后并发症。方法在Kamada“二袖套法”吻合血管的基础上进行改良。肝上下腔静脉用缝合法吻合，门静脉和肝下下腔静脉用袖套法吻合，胆总管采用单管内支架胆管端端吻合法。施行原位肝移植140例，对预实验组60例中并发症的发生情况进行统计分析研究，对手术方式进行相应改进。结果预实验组60只大鼠发生出血、吻合口狭窄、静脉血栓、感染和胆道梗阻等并发症发生率为70％，显著高于实验组（10％）（P〈0．05）。结论熟练细致的手术操作是预防术中和术后并发症的先决条件．提高手术技巧，熟悉各种并发症的原因和预防处理措施，可以显著提高手术成功率，延长大鼠术后存活时间。

The Establishment of the Model of Orthotopic Liver Transplantation and Prevention of Operational Complication in Rat

Objective To establish a reliable rat model of orthotopic liver transplantation and investigate how to prevent the complications of rat orthotopic liver transplantation by improving operation skills.Methods 140 cases of rat liver transplantation had been established with modified cuff technique.The anastomosis of the suprahepatie vena cave（VC）was sutured end-to-end with 6-0 nylon line,and the continuity of infrahepatic VC and portal vein（PV）were established by means of cuff method respectively.The bile duet anastomosis was performed by internal stent.We count the rate of the complications during experiments,and improve the surgery skills. Results 60 preliminary formal experiments were done with a failure rate 10%,it was more below than the expedments（70%）（P〈0.05）.Conclusion The sophisticated and delicate surgical manipulation is the prerequisite of preventing operational complication,enhancing the surgery skill and understanding the reasons and prevention and treatments of each kinds of complication may reduce the occurrence of complications,raise the surgery success rate and lengthen the survival time of rats.