豚鼠至大鼠肝移植肝下下腔静脉套管方法的改进

目的探讨豚鼠至大鼠异种原位肝移植中应用改进的肝下下腔静脉套管方法的手术效果。方法豚鼠和SD大鼠各30只分别作为供、受体,并随机配对分为实验组和对照组。实验组采用改进的肝下下腔静脉套管进行肝下下腔静脉袖套管法吻合。对照组采用常规方法进行肝下下腔静脉袖套法吻合。比较两组的供肝切取时间(切、修肝时间)、受体手术时间、无肝期时间、手术成功率、肝下下腔静脉袖套吻合口附近出血发生率以及术后生存时间。结果实验组和对照组的供肝切取时间分别为(32.2±3.5)min、(45.4±5.7)min,修肝时间分别为(14.5±2.1)min、(9.2±1.8)min,切、修肝总时间分别为(46.7±4.8)min、(54.6±6.9)min,比较差异均有统计学意义(均为P0.05)。两组受体的手术时间分别为(52.7±6.1)min、(53.2±6.5)min,无肝期分别为(16.8±2.1)min、(17.2±2.5)min,比较差异没有统计学意义(均为P0.05)。实验组与对照组的手术成功率分别为93%、53%,比较差异有统计学意义(P0.05)。两组的肝下下腔静脉袖套吻合口附近出血发生率分别为0、38%,比较差异有统计学意义(P0.05)。两组手术成功的动物的术后生存时间分别为(115±24)min、(95±29)min,比较差异无统计学意义(P0.05)。结论应用改进的肝下下腔静脉套管方法进行豚鼠至大鼠原位肝移植,手术成功率高,可用于豚鼠至大鼠原位肝移植实验研究模型的制作。

A modified technique for hepatic inferior vena cara cannula in heterologous orthotopic liver transplantation from guinea pig to rat

Objective To investigate therapeutic effect of modified hepatic inferior vena cava cannula in heterologous orthotopic liver transplantation from guinea pig to rat. Methods Thirty guinea pigs and thirty SD rats were selected as donors and recipients respectively, arid they were randomly divided into experimental group and normal control group. Hepatic inferior vena cava cuff anastomosis was performed using modified hepatic inferior veua cava cannula in the experimental group and conventional technique in the normal control group respectively. Time for liver graft procurement and trimming, surgery time for recipients, time for anhepatic phase, successful rate for operation, hemorrhage incidence around hepatic inferior vena cava cuff anastomosis, and postoperative survival time were compared between the two groups. Results The time for liver graft procurement and trimming was （32. 2 ± 3.5 ） min and （14. 5 ± 2. 1 ） rain in the experimental group respectively. Correspondingly, the time for liver grafts procurement and trimming was （45.4 ± 5.7 ） min and （9.2 ± 1.8 ） miu in the control group respectively. The cumulative time for hepatic resection and repairing was （46.7 ± 4. 8 ） rain and （ 54. 6 ± 6. 9 ） min in the experimental group and the control group respectively. There was a significant difference between the two groups （P 〈 0. 05 ）. However, there was no significant difference in surgery time for recipients and time for anhepatic phase （ all in P 〉 0.05 ）. Successful rate for operation in the experimental group was remarkably higher than that in the control group （93% vs 53% , P 〈 0. 05 ）. Significant difference was also observed in hemorrhage incidence around hepatic inferior vena cava cuff anastomosis （0 vs 38%, P〈0. 05）. However, there was no significant difference in the survival time between the two groups, （115±24） min vs （95 ±29） min, P〉0.05. Conclusion Compared with the conventional method, the modified hepatic inferior vena cava cannula increases the successful rate of heterologous orthotopic liver transplantation from guinea pig to rat and it is advisable to adopt this technique during operation.