大鼠原位肝移植模型的手术操作技巧探讨_临床医学论文.docVIP

大鼠原位肝移植模型的手术操作技巧探讨_临床医学论文 大鼠原位肝移植模型的手术操作技巧探讨_临床医学论文 【摘要】 目的 建立一个稳定的大鼠原位肝移植模型，探讨其手术技巧。方法　 在Kamada“二袖套法”的基础上进行改良。供体改经腹主动脉进行肝脏冷灌注；肝上下腔静脉用连续缝合法吻合，门静脉和肝下下腔静脉用袖套法吻合，胆总管采用单管内支架胆管端端吻合法。结果　 共施行大鼠原位肝移植140例，无肝期平均11 min，手术成功率为97%，大鼠1周存活率为95%。结论　 改良的两袖套法具有操作简便、无肝期短、手术成功率高、大鼠术后存活时间长的优点，是大鼠原位肝移植的理想术式。娴熟细致的外科操作、受体无肝期的长短是决定动物存活的关键。 【关键词】 肝移植 大鼠 动物模型 Techniques of orthotopic liver transplantation in rats YU Rusheng， WANG Yong， QIAN Haixin. Department of General Surgery, the First Affiliated Hospital of Suzhou University， the Key Lab of Clinical Immunology of Jiangsu Province, Suzhou 215006 Abstract Objective To establish a reliable rat model of orthotopic liver transplantation and discuss its operating techniques. Methods The model was established with modified double-cuff method. The liver of donor was perfused through the abdominal aorta with cold fluid. The anastomosis of the suprahepatic vena cave (SVC) was sutured end-to-end with 6-0 nylon line， and the continuity of infrahepatic vena cave (IVC) and portal vein (PV) were connected by means of cuff techniques respectively. The bile duct anastomosis was linked by internal stent. Results One hundred and forty cases of rat orthotopic liver transplantations were performed. The mean time of anhepatic phase was 11 minutes. The 24 hours and 1 week survival rates were 97% and 95%， respectively. Conclusion Our modified double-cuff method has the character of limited anhepatic phase, long survival rates and is convenient and easy to repeat. It is an ideal model. Skilled surgical techniques and shortening the anhepatic phase of recipient are the keys to animal survival. Key words liver transplantation； rats； animal model 大鼠原位肝移植是多步骤，较为复杂的手术， Kamada等[1]创建的双袖套法是进行大鼠原位肝移植的经典方法，许多学者在此基础上又进行了各种改进，优劣不一。我们在参照Kamada法及各家经验[2-3]的基础上, 进一步简化了手术步骤, 改进了肝上下腔静脉的缝合，缩短了无肝期的时间，降低了操作难度，成功地建立了大鼠原位肝脏移植模型，报告如下。 1 材料和方法 1.1 材料　 健康雄性SD大鼠（购自苏州大学动物中心）共280只，质量220～250 g，受体质量略大于供体。受体手术前禁食12 h，自由饮水。肝下下腔静脉、门静脉袖套管由聚乙烯导管制成，门静脉袖套内径为1.7 mm，长约4 mm，肝下下腔静脉袖套内径为2.5 mm，长约3