大鼠原位肝移植术后胆道并发症的影响因素  

Factors related to biliary complications after orthotopic liver transplantation in rats

作　　者：李国林[1] 林浩铭[1] 龙天柱[1] 吕丽虹[1] 徐錾耀[1] 俞建东[1] 许晓婷[1] 闵军[1] 万云乐[1] 

机构地区：[1]中山大学附属第二医院肝胆外科,广州510120

出　　处：《中华生物医学工程杂志》2009年第5期371-375,共5页Chinese Journal of Biomedical Engineering

基　　金：国家自然科学基金项目（30671987）

摘　　要：目的研究大鼠原位肝移植术后胆道并发症的各种影响因素，为建立更稳定的大鼠原位肝移植模型提供实验依据。方法雄性SD大鼠87只，完全随机法分组，其中移植组48只、非移植组36只、假手术组3只，实验共分胆管-胆管重建移植组、胆管-十二指肠重建移植组、胆管-胆管重建＋肝动脉结扎非移植组、胆管-胆管重建非移植组、胆管-十二指肠重建＋肝动脉结扎非移植组、胆管-十二指肠重建非移植组和假手术组7组。各手术处理组以出现明显胆道并发症或移植后14d作为观察时间终点。通过肝脏大体标本肉眼观察、病理学检测和血清学分析等判断胆道并发症的发生率及其严重程度并进行各组间比较。结果移植组总胆道并发症发生率为69．6％，明显高于非移植组（25．0％）和假手术组（0％），差异有统计学意义（均P〈0．05）。在移植组和非移植组中，胆管-十二指肠重建组的胆道并发症发生率明显高于胆管一胆管重建组（90．9％比50．0％，38．9％比11．1％，均P〈0．05）。非移植组中，结扎肝动脉组的胆道并发症高于不结扎肝动脉组（38．9％比11．1％，P〈0．05）。结论经典“二袖套法”大鼠原位肝移植模型尚不完善，仍需进一步改进。就大鼠原位肝移植模型而言，胆管一十二指肠重建方式并非理想的选择。Objective To study the influencing factors of biliary complications after rat orthotopic liver transplantation and to provide evidence for establishment of more stable animal models. Methods Eighty-seven male Sprague Dawley （SD） rats were randomly divided into bile duct to bile duct reconstruction transplant group, bile duct to duodenal reconstruction transplant group, bile duct to bile duct reconstruction non-transplant group with hepatic artery ligation, bile duct to bile duct reconstruction non-transplant group, bile duct to duodenal reconstruction non-transplant group with hepatic artery ligation, bile duct to duodenal reconstruction non-transplant group and sham-operated group, including 48 rats in transplant groups, 36 in non-transplant groups and 3 in sham-operated group. The samples were collected 14 d after the operation or right on the time any significant biliary complication was found. The occurrence and the severity of biliary complications were judged through the gross anatomy, pathologic and serologic changes, and were compared in different groups. Results The incidence of biliary complications was 69.6% in transplant groups, which was much higher than that in non - transplant groups （25.0%） and sham - operated group （0%） with statistically significant differences （both P〈0.05）. Bile duct to duodenal reconstruction groups had more biliary complications than bile duct to bile duct reconstruction groups both in transplant groups and nontransplant groups （90.9% vs 50.0%, 38.9% vs 11.1%, both P〈0.05）. In non-transplant groups, higher incidence of biliary complications was found in the groups with hepatic artery ligation than in the others （38.9% vs 11.1%, P〈0.05）. Conclusion The animal model of rat orthotopic liver transplantation established with classical ＂two cuff method＂ may not appear to be perfect and yet remains necessary for further modification. Bile duct to duodenal reconstruction is not shown to be an ideal rat model of orthotopic liver transplantation.

关 键 词：肝移植 手术后并发症 模型 动物 血清学分析 大鼠 

分 类 号：R657.3[医药卫生—外科学] R657.4[医药卫生—临床医学]