猪辅助性带胰头及十二指肠肝肠联合移植的研究  

Auxiliary en-bloc liver-small bowel transplantation with duodenum and partial pancreas preservation in pigs

作　　者：尹震宇[1,2] 王效民 李宁[1] 李幼生[1] 倪小冬[1] 蒋峰[1] 黎介寿[1] 

机构地区：[1]南京军区南京总医院普通外科研究所 [2]福建省厦门中山医院肝胆外科361004

出　　处：《中华实验外科杂志》2005年第5期555-557,共3页Chinese Journal of Experimental Surgery

基　　金：国家自然科学基金资助项目(39070828)

摘　　要：目的介绍猪辅助性带胰头及十二指肠的肝肠联合移植(LSBT)模型技术及其免疫抑制治疗.方法 40头杂交长白猪分为两组,每组20头,组内进行辅助性带胰头及十二指肠的LSBT 10次.其中A组未用免疫抑制剂治疗,B组采用环孢素A和甲基强的松龙治疗.结果 A组动物术后成活时间为(10.33±1.93) d(7～25 d),B组全部动物成活超过30 d.在没有应用体外转流的情况下,可以耐受血液动力学的波动,血液动力学指标(B组)可以在血流再通后2 h恢复正常.B组猪术后血液、尿液和腹腔引流液中的淀粉酶一过性升高,但在1周后回落到术前水平,活检没有发现严重胰腺炎.结论猪辅助性带胰头和十二指肠的LSBT是一种可行的、安全的移植模型,这一模型可以简化传统肝肠移植的技术,应用环孢素A和甲强龙可以有效的抑制猪肝肠移植后急性排斥反应.Objective To introduce an auxiliary combined liver-samll bowel transplantation model with the preservation of the duodenum,partial head of pancreas and hepatic biliary system in pigs.Methods Forty outbreed long-white pigs were randomized into two groups,and the auxiliary composite liver-samll bowel allotransplantations were performed in 10 long-white pigs in each group with the recipient liver preserved.Group A was not treated with immunosuppressive drugs,while group B was treated with Cyclosporine A and Methylprednisolone.The hemodynamic changes and amylase of body fluid were analyzed.Results The average survival time of the animals was (10.33± 1.93) days (7 to 25 days) and more than 30 days in group A and B respectively.The pigs could tolerate the homedynamic fluctuation during operation and the parameters would recover to normal 2 h after blood reperfusion.The transient high amylase level would decrease to normal one week after operation and the autopsy showed no pancreatitis.Conclusion Auxiliary en-bloc liver-small bowel transplantation with partial pancreas preservation is a feasible and a safe model with simplified surgical techniques for composite liver/small bowel transplantation.The acute rejection of the grafts can be shielded from the treatment of Cyclosporine A and Methyprednisolone.

关 键 词：肝肠联合移植 十二指肠 辅助性 胰头 血液动力学指标 猪 免疫抑制治疗 甲基强的松龙 急性排斥反应 环孢素A 免疫抑制剂 腹腔引流液 严重胰腺炎 模型技术 体外转流 移植模型 B组 一过性 淀粉酶 肠移植 移植后 甲强龙 成活 

分 类 号：R617[医药卫生—外科学]