同种异体犬单肺移植的实验研究.docVIP

同种异体犬单肺移植的实验研究 医学护理论文网 ［摘要］? 目的? 通过进行同种异体犬单肺移植并观察移植肺功能及血流动力学情况，掌握供肺的切取、灌注、保存、修剪，及供肺植入受体的手术技巧，为进行人单肺移植打下基础。方法? 对7对体重匹配的杂种犬进行单肺移植，每次手术监测并比较移植肺功能及血流动力学情况。结果? 供肺的切取、灌注、保存及修剪均顺利；供体肺左房、肺动脉、支气管吻合顺利，效果良好；术后移植肺功能良好，血流动力学稳定。结论? 掌握了犬单肺移植的全过程，对供肺切取、灌注、保存、修剪及移植肺植入的方法有新的体会，为人体单肺移植打下了良好的基础。 ??? ［关键词］? 犬，同种；肺移植；移植 ????? Experimental study on allograft canine single lung transplantation ??? ［Abstract］? Objective? To master the way of resection，perfusion，preservation，repair，and implantation skills of donor lungs through an experimental research on canines lung donor and collection of lung function and hemodynamic data，which will lay the basis for the further study on human lung transplantation.Methods? Single lung transplantation was performed in 7 weightmatched pairs of dogs，and lung function and hemodynamic data was collected and analyzed.Results? Resection，perfusion，preservation，repair，and implantation of donor lungs was mastered successfully.After implantation，recipients hemodynamics was stable，and lung function was found to be excellent.Conclusion? The skills of single lung transplantation on canines have been mastered successfully.Further experience of resection，perfusion，Preservation，repair，and implantation of donor lungs have been acquired.It will help prepare for the human lung transplantation. ??? ［Key words］? canine，homologous；lung transplantation;transplantation ??? 肺移植是治疗肺实质及肺血管性终末期肺疾病的唯一有效方法。论文百事通为了在临床成功开展肺移植手术，我们于2005年6月成功进行同种异体犬单肺移植7次，现将有关供肺的切取、灌注、保存、修剪及供肺植入受体手术操作的经验及体会报告如下。 ??? 1? 材料与方法 ??? 1.1? 实验动物? 体重匹配的杂种犬14只，雄性6只，雌性8只，体重12.5～13 kg，购于哈尔滨医科大学动物实验中心。随机分为供体和受体两组。 ??? 1.2? 供肺切取及保存? 盐酸氯胺酮(10 mg/kg)和硫酸阿托品(0.01 mg/kg)肌肉注射作为麻醉诱导。静脉给予戊硫代巴比妥钠(2.5 mg/kg)和维库溴铵(0.1 mg/kg)后进行气管插管。供体呼吸机通气，潮气量20 ml/kg，给予5 cm H2O的PEEP，呼吸频率15次/min，吸入0.5%氟烷和氧气的混合物维持麻醉。供体犬取平卧位，碘伏消毒3遍。经胸前“U”型切口，逐层切开皮肤、皮下组织及肌层，取前胸壁“U”字形皮肤切口，切断右侧肋软骨，翘起胸骨右缘后再切断左侧肋软骨，游离胸骨下端并将胸骨向头侧上翻，在胸骨角处折断。纵行剪开心包牵向两侧。经周围静脉注射肝素3 mg/kg，上腔静脉、下腔静脉及横窦分别套带；切下右肺组织1块留作病理检查；距肺动脉起始部远端约1～1.5 cm缝荷包线，用尖刀切开肺动脉约2 mm切口，将内径2 mm冲灌洗插管插入肺动脉内，荷包线打结固定；分别结扎