大鼠30%小体积肝移植模型三种切肝方法的比较  

Different methods of liver lobe resection for a rat model of 30% small-for-size liver transplantation

作　　者：姚爱华[1] 浦立勇[1] 李相成[1] 姜超[1] 马跃峰[1] 刘现忠[1] 仲跻魏[1] 王学浩[1] 

机构地区：[1]南京医科大学第一附属医院肝脏移植中心,江苏省南京市210029

出　　处：《世界华人消化杂志》2007年第33期3479-3483,共5页World Chinese Journal of Digestology

基　　金：国家自然科学基金;No.30671992~~

摘　　要：目的:探讨不同肝叶选取和切肝方法对小体积肝移植术后生存率的影响,以建立理想的成功率高的大鼠30%小体积肝移植模型.方法:采用以Kamada的"二袖套法"非动脉化大鼠原位肝移植模型为基础,建立大鼠30%小体积肝移植模型.实验分为3组:Ⅰ组:中叶供肝的30%小体积肝移植组(n=28):Ⅱ组:右中叶和右叶供肝的30%小体积肝移植组(n= 15);Ⅲ组:改进切肝方法的30%中叶供肝小肝移植组(n=36).观察3组术后并发症和7d生存率.结果:Ⅱ组切肝时间和术后肝后下腔静脉狭窄的发生率明显低于Ⅰ组(11±3 min vs 13±2 min,P=0.0305;0/15 vs 8/28,P=0.036),但胆漏的发生率高于Ⅰ组(4/15 vs 0/28,P=0.011).Ⅲ组肝后下腔静脉狭窄的发生率明显低于Ⅰ组(1/36 vs 8/28,P=0.008),其他并发症发生率各组间无明显差别.术后7d生存率Ⅰ(33%)、Ⅱ(50%)、Ⅲ(60%)组间无统计学差别.结论:采用中叶供肝、改进切肝技术可以建立具有更稳定的大鼠30%小体积肝移植模型.AIM： To explore an effective and viable way to establish a 30% small-for-size liver transplantation model in rats. METHODS： Animals were divided into the following groups： group Ⅰ （n = 28）, 30% liver transplantation using a median lobe graft; group Ⅱ （n = 15）, 30% liver transplantation using right lobe and right median lobe graft; and group Ⅲ （n = 36）, 30% liver transplantation using a median lobe graft, with an improved technique of lobe resection. Male Lewis rats were used as donors and recipients, and the grafts were implanted according to Kamada＇s two-cuff method. Sevenday survival and technical complications, in-cluding bleeding, IVC or portal vein stricture, and bile leakage, were compared between the groups. RESULTS： Compared to group Ⅰ, the time for liver lobe reduction in group Ⅱ （11 ± 3 min vs 13 ± 2 min, P = 0.0305） was shorter, with fewer IVC strictures （0/15 vs 8/28, P = 0.036）, but more bile leakages （4/15 vs 0/28, P = 0.011 ）. After improvement of the lobe resection method, the incidence of IVC strictures was significantly decreased when comparing group Ⅲ with group Ⅰ （1/36 vs 8/28, P 〈 0.01）. Other complications showed no significant difference. There were no significant differences in the 7-d survival rate between the three groups （group Ⅰ, 33%, 5/15; group Ⅱ, 50%, 6/12; and group Ⅲ, 60%, 9/15）, although group З had more survivors at 7 d after liver transplantation. CONCLUSION： With improved method of lobe resection, a more effective and viable 30% small- for-size rat liver transplantation model with a median lobe graft can be established.

关 键 词：肝移植 小体积 大鼠 肝切除 

分 类 号：R657.3[医药卫生—外科学] R332[医药卫生—临床医学]