小型猪胰肾联合移植术麻醉管理的实验研究

目的:研究小型猪胰肾联合移植术合适的麻醉管理方法,了解术中受体血流动力学变化情况.方法:20头小型猪分别作为供、受体配对进行胰肾联合移植,氯胺酮基础麻醉后行气管插管全身麻醉,监测动脉压、中心静脉压、心率.术中根据血流动力学情况调节输液速度,吻合血管开放后加快补液,并输入采自供体的血液.结果:受体在髂总静脉阻断后动脉压和中心静脉压明显降低、心率增快:髂总静脉开放后动脉压和中心静脉压增高,心率减慢;髂总动脉阻断后动脉压和中心静脉雎增高,而开放后动脉压和血流动力学中心静脉压明显降低、心率增快;吻合血管开放后动脉压和中心静脉压明显降低,心率增快.结论:加强受体循环系统的监测和管理是保障胰肾联合移植手术成功的关键.

Study of anesthesia management for simultaneous kidney-pancreas transplantation in miniature pig

Objective:To explore the appropriate anesthesia management for simultaneous kidney-pancreas transplantation in miniature pigs,and to find out the hemodynamic state changings of recipients. Methods:20 miniature pigs were devided into donors and recipients randomly to be operated. The miniature pigs were anesthetized with ketamine,then were general anesthetized with endotracheal intubatton.During operation, mean arterial pressure, central venous pressure and heart rate were monitored. Fluid replacement for recipients was adjusted according to the hemodynamic state,and was accerated after the reopening of inosculated blood vessels. Blood obtained from donors was also infused. Results:Recipient's mean arterial and central venous pressure were significantly decreased,heart rate was significantly increased after the block of common iliac veins,and they were changed reversely after the reopening of common iliac veins. Hemodynamic state was also significantly changed after the block or reopening of common iliac arteries and inosculated blood vessels.Conclusion:Recipient's mean arterial pressure,central venous pressure and heart rates were significantly changed during blood vessels inosculating in simultaneous kidney-pancreas transplantation in miniature pig. Therefore,enhancing the monitoring and management for circulatory system were the key point of success for simultaneous kidney-pancreas transplantation.