大鼠腹腔心脏异位移植模型的改进

目的改进传统大鼠腹腔心脏异位移植模型,提高成功率。方法完全摘取供体心肺,离体供心灌注停跳;在松弛的状态下结扎静脉系统,端侧吻合采取间断+连续的缝合方法;先开放远心端再开放近心端,同时按摩心脏。结果传统方法组(n=20)成功14只,动脉吻合口出血2只、心脏复跳失败2只、吻合口狭窄2只;改进方法组(n=20)成功18只,2只死于吻合口出血。传统方法组手术成功率为70%,改进方法组为90%(P>0.05)。结论①快速摘取心肺,离体心脏灌注保护,操作简单,热缺血时间短,效果肯定,对供心的保护效果好。②松弛的状态下结扎静脉系统,对心房、冠脉影响非常小。③采取间断+连续的缝合方法,因吻合口狭窄造成手术失败的可能性很低,④合理定位,避免吻合完毕供心动脉扭曲,从而影响复跳。⑤注意受体鼠的保温、消毒及血容量丧失非常关键。⑥利用心外膜起搏导线获得了供心的动态心电图。

Improvement of a rat model of heart transplantation

Objective To improve the techniques for establishment of a stable and reproducible animal model of heart transplantation in rat for further research on the preservation of donor heart. Methods To obtain the donor`s heart and lung quickly at first. Then the hearts were arrested with HTK solution. To tie off all systemic and pulmonary inflow in a mass ligature without tension. End-toside anastomoses were performed from the donor ascending aorta to the recipient abdominal aorta and from the donor pulmonary artery to the recipient inferior vena cava. Results 20 rat heart transplantation were performed, 2 rats died of anastomofie bleeding, the total successful rate was above 90%. Conclusion The modified techniques and careful operative management can contribute to better Success in heart transplantation in rats.