供心保存研究中大鼠心脏异位移植模型的制作

目的 为探索心脏移植中供心保护快速可靠的研究方法。方法 快速摘取供体心肺，采用离体供心灌注停跳；在松弛的状态下结扎静脉，将其胸主动脉与受者的腹主动脉、肺动脉与受者的下腔静脉端侧吻合，采取间断+连续的缝合方法；开放血流时，先开放远心端再开放近心端，同时按摩心脏。结果 预实验组(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；正式实验组(n=20)成功18只，2只死于吻合口出血。预实验组手术成功率为70％，正式实验组为90％(p>0.05)。结论 （1）快速摘取心肺，然后再进行离体心脏灌注保护，操作简单，热缺血时间很短，灌注效果肯定，对供心的保护效果好。（2）离体心肺组织结扎静脉，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。

Establishment of a Rat Model of Heart Transplantation and Study on the Preservation of Donor Heart

Objective To improve the techniques for establishment of a stable and reproducible animal model of heart transplantation in the study of preservation of donor heart. Methods The donor heart and lung were quickly extracted and arrested with HTK solution. All the systemic and pulmonary inflow were tied off in a mass ligature without tension. End-to-side 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 40 heterogenous heart transplantations were performed,5 rats were died of anastomofie bleeding,2 were died of the stenosis of anastomosis and 1 was died of the failure of heart rebound,and the total success rate was about 90%(P > 0.05). Conclusion The improved techniques and carefully operative management may be useful for success in rat heart transplantations.