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作 者:郭骏[1] 樊雪频[1] 曹桂红[1] 武夏明[1] 张维涛[1] 付春香[1]
出 处:《泰山医学院学报》2008年第10期754-756,共3页Journal of Taishan Medical College
摘 要:目的建立家兔自体肾移植模型用于肾移植的实验研究。方法腹部正中切口。游离出肾动脉开口上、下方各10 cm腹主动脉及肠系膜上动脉近段。用血管夹先后阻断腹主动脉下段、肠系膜上动脉近段及腹主动脉上段。用5.5号头皮针穿刺腹主动脉下段,接冷灌注管,以0℃~4℃含肝素(100μ/ml)的乳酸林格氏液灌注肾脏。肾脏呈灰白色、肾静脉血色变浅后停止灌注,接着用血管夹将两侧肾蒂近端阻断。顺序松开腹主动脉下段、肠系膜上动脉近段及腹主动脉上段的血管夹,恢复血流。肾脏表面覆碎冰屑。切断肾动、静脉,按自体肾移植,原位吻合肾动、静脉,恢复肾脏血供,同时清除碎冰屑。逐层关闭腹部切口。结果术后20~40 min家兔完全苏醒,能行走、饮水。共完成家兔自体肾移植模型26例,其中2例死亡,成功率93%。由于实验的需要,分别于术后第4、7、14、28天处死实验兔。开腹观察两侧肾的大小、颜色、质地无明显差别。显微镜检查两侧肾的肾小球和肾小管未见明显变化。术后第7、14天测血尿素氮(BUN)、肌酐(Cr)值,均在正常范围内。结论家兔自体肾移植模型制作简单、科研成本低,可用于肾移植的实验研究。Objective: To produce autogeneous renal transplantation models in rabbits for experimental study. Methods: Through the mid- abdominal cision, the abdominal aorta (AA)-10 cm was dissociated from the renal artery root upwards and downwards, and the proximal segment of the superior mesenteric artery (SMA). The blood flow of the lower part of AA, the proximal segment of SMA and the upper part of AA was clamped in succession. The lower part of AA was punctured with a scaple needle connecting with a tubule for perfusion. Fluid Lactic Acid-Linger (0 ℃-4 ℃ ) containing heparin ( 100 μ/ml) was perfused until the color of the kidneys turned pale and the renal vein blood was highly diluted. Then the proximal segment of the renal pedicle was clamped bilaterally. Next the formerly clamped arteries was opened. The model of the cold ischemia state of transplantation kidney in clinical operations was made, the kideys kept in low temperature with ice chips wrapped in pledgers. The renal pedicle clamps and ice chips were removed 15 minutes later to restore the normal blood flow. The abdominal cision Closed was closed layer by layer. Results: We performed 18 cases of autogeneous renal transplantation model in rabbits, of which 2 cases died, and the survival rate was 89%. The operational rabbits woke 20 to 40 minutes after operation, and were able to run and drink. The models were sacrificed respectively 4,7,14,28 days later. Nakedly the bilateral kidneys showed no significant differences in size, color and texture. Microscopically no significant pathological changes were found in renal glomerulars and in renal tubules. BUN (Blood Urea Nitrogen) and Cr (creatinine) were among normal ranges when tested 7 and 14 days later. Conclusion: The autogeneous renal transplantation model in rabbits is simple to produce, and the expenditure for study is very low. It can be used for experimental study of renal transplantation.
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