三种供体阴茎灌注方法的特点比较  

Three perfusion techniques for cadaveric donor penises

作　　者：张利朝[1] 胡卫列[1] 吕军[1] 赵永斌[1] 杨菁华[1] 

机构地区：[1]解放军广州军区广州总医院泌尿外科,广东省广州市510010

出　　处：《中国组织工程研究与临床康复》2007年第16期3116-3118,共3页Journal of Clinical Rehabilitative Tissue Engineering Research

摘　　要：目的:比较供体阴茎腹主动脉灌注、髂总动脉灌注和髂内动脉灌注法的临床观察指标,试图寻找最佳的尸体阴茎灌注方法。方法:广州军区广州总医院于2004-03/2005-09采用腹主动脉灌注法、髂总动脉灌注法和髂内动脉灌注法取得供体阴茎各15例,共获取供体阴茎45个。①腹主动脉灌注法:于腹主动脉分叉上方6cm处做切口,切口近端插管灌注肝、肾,切口远端套入一粗线,插入20F气囊导尿管,深约5cm。②髂总动脉灌注法:分别于腹主动脉与髂总分叉处套入一粗线,上提粗线,剪开髂总动脉前壁,插入自制12F硅胶管,深约4cm。③髂内动脉灌注法:分别于髂总动脉与髂内动脉分叉处套入一粗线,上提粗线,剪开髂内动脉前壁,插入自制10F硅胶管,深约3cm。分析45例供体阴茎灌注临床资料,比较3种灌注方法切取供体阴茎的手术时间、热缺血时间、灌注液用量和灌注不良率。结果:①手术时间方面,腹主动脉灌注法短于髂总动脉灌注法[(3.28±1.02,4.96±1.84)min(P<0.05)],髂总动脉灌注法短于髂内动脉灌注法(6.02±2.25)min(P<0.05)。②热缺血时间方面,腹主动脉灌注法热缺血时间短于髂总动脉灌注法[(1.08±0.85,3.08±1.12)min(P<0.05)],髂总动脉灌注法热缺血时间短于髂内动脉灌注法(4.14±1.81)min(P<0.05)。③灌注不良率方面,腹主动脉灌注法明显低于髂总动脉灌注法[0,10.25%(P<0.05)],髂总动脉灌注法低于髂内动脉灌注法(15.23%)(P<0.05)。④3组灌注方法的灌注液用量差异无显著性意义(P>0.05)。结论:腹主动脉灌注法切取供体阴茎操作简单,手术时间和热缺血时间均较短,灌注不良发生率低,优于髂总动脉和髂内动脉灌注法。AIM： To compare the clinical indices of donor penis by using abdominal aorta perfusion, bilateral common iliac artery perfusion and bilateral intemal iliac artery perfusion, and explore the best perfusion for cadaveric donor penis. METHODS： A total of 45 donors were enrolled between March 2004 and September 2005 in the Guangzhou General Hospital of Guangzhou Military Area Command of Chinese PLA. Abdominal aorta perfusion, bilateral common iliac artery perfusion and bilateral intemal iliac artery perfusion were adopted in different periods of time, 15 donors for each method. （1）Abdominal aorta perfusion： The artery 6-cm above bifurcation of abdominal aorta was cut and 20F urethral catheter was inserted about 5 cm from distal incision. （2）Bilateral common lilac artery perfusion： The artery below bifurcation between abdominal aorta and iliac artery was cut and 12F silica gel catheter was inserted about 4 cm.（3）Bilateral internal iliac artery perfusion： The artery below bifurcation between iliac artery and intemal iliac artery was cut and 10F silica gel catheter was inserted about 3 cm. Clinical data of 45 donors were retrospected. Operation time, hot ischemia time, quantity of preservation solution and poor perfusion of donor penis were observed and compared among the three techniques. RESULTS： （1）Operation time of abdominal aorta perfusion was shorter, than that of bilateral common iliac artery perfusion [（3.28±1.02）, （4.96±1.84） minutes, P 〈 0.05], which was shorter than that of bilateral intemal iliac artery perfusion [（6.02±2.25） minutes, P 〈 0.05].（2）Hot ischemia time were shorter by abdominal aorta perfusion than by bilateral common iliac artery perfusion [（1.08±0.85）, （3.08±1.12） minutes, P 〈 0.05], which were also shorter than by bilateral intemaliliac artery perfusion [（4.14±1.81） minutes, P 〈 0.05]. （3）Poor perfusion of donor penis was obviously lower by abdominal aorta perfusion than by bilateral common lilac artery perfusion �

关 键 词：阴茎/外科学 组织供者 器官移植 

分 类 号：R617[医药卫生—外科学]