“开放灌注四牵三缝二横一拉”法大鼠肝移植.docVIP

“开放灌注四牵三缝二横一拉”法大鼠原位肝移植术 刘静 1 孙尔维2 汪爽2 李冉冉1 聂凯1 杨爱国1 高毅2 钟世镇3 摘要 目的：进一步改进双袖套法大鼠原位肝移植手术方法。方法：在Kamada的大鼠原位肝移植已改进方法（方法1）的基础上，进一步改进方法（方法2）即：供、受体腰背部垫高、腹壁横切口、弹性拉钩的牵引、供肝开放灌注、受体术前用抗菌素、自体血液回输、肝上下腔静脉（SVC）的四方向牵引、SVC 的“三定点”、“三缝一拉”的缝合方法、小针钩驱气。用方法1及方法2分别进行20次大鼠原位肝移植。结果：用方法1、方法2（“开放灌注四牵三缝二横一拉”法）行大鼠原位肝移植的无肝期分别为：16±2min、11±2min,手术时间分别为：146±22min、94±26min,7天生存率分别为：90%、100％。结论：方法2行大鼠肝移植，明显缩短了无肝期、提高移植后大鼠生存率，方法2是一种较好的大鼠原位肝移植的方法。 关键词：大鼠 ；肝移植；技术改进 A simple effective method for rat orthotopic liver transplantation named “pulling only one times while having three stitches in SVC”. LIU Jing﹡,SUN Er-wei WANG Shuan,et al. ﹡Department of General Surgery ,the 175th Hospital of PLA,Zhangzhou 363000 Abstract: Objective To improve the method of rat othotopic liver transplantation using two cuffs and shorten the period of non liver ,and to enhance the success rate of operation and suvival rate.Methods Two methods were used in the course of this experiment.The first method was a innovated method from Kamada’s method.The second method was a innovated method from the first method. The second method is composed of techniqes as following:Rats’ back-waist is raised with spacer ; Elastic claws for dragging hypochondrium and lateral incisions on rats’abdomen wall are used; Portal vein are not ligating to the duct which is used for instillating donor’s livers; Recipients are injected penicillin before operation for recipients begin to be carried out and are self-transfused ; SVC is pulled to the left ,the right, the head and the tail; Suture silk is pulled only one times per having three stitches in SVC; SVC is fixed in three points;Gas is driven out of veins using a bent needle connecting injector.Rat orthotopic liver transplantation was carried out in 20 cases by the first method and other 20 cases by the second method . Results The time of non liver was 16±2min、11±2min by the first method、the second method respectively.The time of operation was 146±22min、94±26min respectively.Survival rates