大鼠颈部异位肾移植术  

STUDY ON SURGICAL TECHNIQUES FOR CERVICAL ECTOPIC RENAL TRANSPLANTATION IN RAT

作　　者：朱亮[1] 宫德正[1] 邹原[1] 李幼生[2] 吴云红[3] 袁博[1] 关莉莉[1] 吴琼[1] 李红玉[1] 刘靖[1] 

机构地区：[1]大连医科大学生理教研室,辽宁大连116044 [2]南京军区南京总医院全军普外科研究所 [3]大连医科大学社会科学和管理科学学院

出　　处：《中国修复重建外科杂志》2008年第7期873-876,共4页Chinese Journal of Reparative and Reconstructive Surgery

基　　金：辽宁省教育厅课题资助项目(2004F088);江苏省医学领军人才课题资助项目(200710);国家重点基础研究发展计划(973)资助项目(2003CB515502)~~

摘　　要：目的建立一种简单、稳定、成功率高的大鼠颈部异位肾移植模型。方法取健康成年雄性近交系清洁级Wistar大鼠208只,体重220～260g,随机配对。整块获取带肾动脉、肾静脉和带膀胱瓣输尿管的供肾,血管重建采用供体肾动脉与受体的左颈总动脉套叠式吻合、供体肾静脉与受体右颈外静脉套管吻合。供肾输尿管远端行膀胱瓣皮肤造口。结果共进行大鼠异位肾移植术104次,其中预实验阶段62次,成功50次(80.6%),失败12次,主要原因为麻醉意外、动脉吻合口血栓和大出血、静脉空气栓塞、静脉闭塞等;正式实验42次,成功40次(95.2%),失败2次,分别为迟发性动脉吻合口出血和吻合口血栓引起。手术时间(40±6)min,其中供体手术时间(20±5)min,供肾修整时间(8±2)min;受体手术时间(18±3)min,其中动脉吻合时间(5±2)min,静脉吻合时间(2±1)min。移植肾冷缺血时间(15±3)min。移植术后1周移植肾血供良好,移植肾均长期存活(超过6个月)。6个月时受体大鼠一般状况良好,生长发育正常。结论大鼠颈部异位肾移植操作简便,冷缺血时间短,成功率高。Objective To establish a simple and stable cervical ectoplc renal transplantanon rat model that increase surgical successful rate. Methods A total of 208 male inbred Wistar rats （weighing 220-260 g） were randomly served as donors and recipients. The graft consisting of kidney, renal vein （RV） and renal artery （RA） was obtained, and perfused in situ. The donor RA was end-to-end anastomosed to the recipient left common carotid artery （CCA） by using of＂sleeve＂ anastomosis, and the donor RV to the recipient right external jugular vein by using of ＂cuff＂ technique. The distal end of the ureter was brought out to form cervical cutaneous stomas. Results A total of 104 ectopic renal transplantations were performed in rats, including stages of the pre-experiment （62 operations） and experiment （42 operations）. The success rates of the two stages were 80.6% and 95.2%, respectively. The causes of failure in the pre-experimental stage were anesthesia accidents, thrombosis of the arterial anastomosis, massive hemorrhage, air embolism and phlebemphraxis. In the experimental stage, 2 rats died due to late anastomotic hemorrhage and thrombosis. The remaining 40 transplanted kidney survived more than 6 months. The time for surgery was （40 ± 6） minutes, the average time for donor surgery was （20 ± 5） minutes, the preparation time for the graft was （8 ± 2） minutes, the operative time for the recipient was （18 ± 3） minutes, including the time for the arterial anastomosis （5± 2） minutes and venous anastomosis （2 ± 1） minutes, the cold ischemia time of graft was （15 ± 3） minutes. Conclusion The cervical ectopic renal transplantation technique has the advantages of easy-and fast-to-perform, shorter operation and cold ischemia time, higher successful rate.

关 键 词：肾移植 异位 动物模型 套叠吻合法 套管吻合法 

分 类 号：R-332[医药卫生]