二种不同成份灌洗液肺保存效果的对比

目的 比较2种不同成份肺灌洗液的肺保存效果.方法 将犬分成2组,一组供肺采用改良的Euro-Collins液(含高钾,钾浓度108mmol/L)灌洗,另一组用低钾葡萄糖液(LPG液,钾浓度4 mmol/L)灌洗.4℃保存6小时后行异体左肺移植,保留受体的右肺.术后10分钟～72小时定时阻断右肺动脉血流,采股动脉血作血液气体分析,并作病理检查.结果 改良的Euro-Collins液和LPG液灌洗的肺移植后即刻受体动脉血氧分压(PaO2)分别为(17.3±6.2)kPa和(19.7±7.0)kPa.CO2分压(PaCO2)分别为(5.28±1.17)kPa和(4.8±0.7)kPa,两组比较,P>0.05,移植后72小时的PaO2分别为(14.6±6.1)kPa和(18.4±7.6)kPa,PaCO2分别为(4.2±0.9)kPa和(4.6±0.7)kPa,两组比较,P>0.05.移植肺组织光镜和电镜观察发现,灌洗后即刻及保存6小时的组织学改变主要表现为肺泡上皮及毛细血管上皮细胞肿胀、肥大、变性,移植后72小时可见肺泡内有渗出、淋巴细胞浸润及血管壁增厚,2个组的病理改变相似.结论 含高钾的改良Euro-Collins液及含低钾的LPG液肺保存效果相似,灌洗液中的K+浓度并非影响移植肺功能的关键因素.

The comparative study on pulmonary preservation with two different formula lung flushing solutions

Objective To compare the effects of the lung preservation with two different formula lung flushing solutions.Methods A newly canine left lung allotransplantation model was used.Twenty dogs were divided into two groups.Two types of flushing solutions were used:group A received modified Euro-Collins solution(E-C solution,K+ 108 mmol/L),group B low-potassium-glucose solution(LPG solution,K+ 4 mmol/L).After the pulmonary artery of donor dogs was flushed by E-C solution or LPG solution,the allograft was stored at 4℃ for 6 h.Then the left lung was transplanted into the recipient dog.Lung function and histological changes were studied immediately and 6,12,24,48 and 72 h after transplantation.Inflatable cuffs were placed around right pulmonary artery to permit the independent study of the transplanted lung.Results The E-C solution and LPG solution provided similar immediate and 6～72 h function of the preservation lung.Histological findings of the two groups were also very similar.Conclusion Potassium concentration in flushing solution is not the key factor to affect the effect of lung preservation.