应用改良Kort法建立猪节段小肠移植动物模型的稳定性评估  

Stability of animal models of porcine segmental small intestine transplantation established with modified Kort method

作　　者：邹小明[1] 闫朝岐[1] 袁友萍[2] 宋茂力[1] 李晓林[1] 

机构地区：[1]哈尔滨医科大学附属第二医院普外科,黑龙江省哈尔滨市150086 [2]哈尔滨医科大学附属第二医院理疗科,黑龙江省哈尔滨市150086

出　　处：《中国临床康复》2006年第1期94-96,共3页Chinese Journal of Clinical Rehabilitation

基　　金：黑龙江省科学技术计划"攻关"资助项目(GC05C40706);黑龙江省教育厅科研项目(10551125);哈尔滨医科大学附属第二医院基金(200504)~~

摘　　要：目的:观察应用改良Kort法建立的稳定性猪节段性小肠移植模型的特点。方法:本实验于2004-02/2005-12在哈尔滨医科大学附属第二医院完成。杂种小猪30只,分为供体、受体各15只。主要采用动脉袖改良吻合口,连续缝合,术后受体不用肝素化等改良的Kort法逆建立比较稳定的猪小肠移植动物模型。①供体手术:正中切口开腹,盐水纱布保护肠管,将结肠全部切除,按需要保留近段空肠。在肠系膜上动脉下方和腹腔动脉上方两端结扎腹主动脉,穿刺两结扎线之间的腹主动脉,4℃肝素盐水500mL(肝素100mg、灌洗压力为7.8～9.8kPa)灌洗,直至肠系膜含和肠壁血管床完全透明。在两结扎线之间剪断腹主动脉,获取腹主动脉袖,不灌洗肠腔,切除供体肠管后置于4℃生理盐水中保存。②受体手术:正中切口开腹,保留十二指肠空肠曲以下10cm和末段回肠10cm,切除其余小肠;将供体肠系膜上静脉与受体下腔静脉行端侧吻合。将供体腹主动脉袖一端与受体腹主动脉行端侧吻合,自动脉袖另一端注入生理盐水,排净腔内气泡后将残端结扎。松开腹主动脉血管夹,将供肠两端分别与受体空肠、回肠行端端吻合。40～45℃生理盐水冲洗腹腔,直至吸引出的冲洗液变温暖为止。③术后评估:观察猪的一般状态、生存时间及并发症。术后第7天,如受体存活,可认为手术成功。结果:受体15只杂种小猪均进入结果分析。①节段性小肠移植手术成功率为80%(12/15)②失败原因:静脉血栓1只,失血1只,其他。原因1只。12例存活超过7d,平均存活了9d左右,最长存活超过14d。③模型制作操作技术特点:供体小肠保存时采用血管最适灌洗压力7.8～9.8kPa进行单纯血管灌洗;受体术前禁食8～10h;吻合时移植肠管置于腹外,用冰盐水纱布包裹;吻合过程中间断向肠管表面滴注4℃生理盐水降温处理。结论:应用改良Kort法建立的猪节段小肠移AIM： To observe the characters of the models of porcine segmental small intestine transplantation established with modified Kort method. METHODS： The experiment was carried out in the Second Affiliated Hospital of Harbin Medical University from February 2004 to December 2005. Thirty porcines, weighing averagely 15-20 kg, were divided into half donators and half acceptors. The modified kort method mainly included modified artery stoma, continuous suture and without heparinize after operation in the acceptor. ①Donator operation： Opened abdomen with median incision, protected the intestinal with brine gauze, excised all colon, reserved nearby jejunum according to the desire, ligatured abdominal aorta between underneath of the superior mesenteric artery and above of the celiac artery, stabbed the celiac artery between this two ligatures, douched with 4℃ heparin brine 500 mE （contain heparin 100 mg, douche pressure 7.8-9.8 kPa）, until the mesentery and vascular bed in intestinal wall were completely transparent, sheared the abdominal aorta between the ligatures, obtained abdominal aorta sleeve, cut intestinal and conserve it in 4℃ normal saline. ②Acceptor operation： Opened abdomen with median incision, cut off all small intestine except 10 cm intestinal below duodenojejunal flexure and the end segment of 10 cm ileum, used end-to-side coincidence between superior mesenteric vein （donator） and inferior vena cava （accepter） in one side, poured in normal saline from another side of the artery sleeve to flush air bubble out in the blood vessel, ligatured stump, clamped artery clamp in the abdominal aorta, used side-to-slde coincidence between donator＇s intestinal and acceptor＇s jejunum ileum and washed abdominal cavity with 40-45℃ normal saline, up to the flush out liquid became warmth. ③Evaluation after the operation： General state, live time and complication of the porcine were observed. The surgical operation was successful if the acceptor was survived at the 7^th day. RESULTS： Fi

关 键 词：移植 猪 小肠 模型 动物 改良Kort法 节段小肠移植 稳定性评估 

分 类 号：R656.7[医药卫生—外科学]