大鼠右侧供肾移植中肾静脉吻合方式的比较研究  

A comparison study on venous anastomosis for right donor kidney transplantation in rats

作　　者：邓新军[1] 刘永光[1] 郭颖[1] 李民[1] 岳良升[1] 范礼佩[1] 陈桦[1] 张建强[1] 魏亚非[1] 何敏毅[1] 赵明[1] 

机构地区：[1]南方医科大学珠江医院器官移植科,广州510282

出　　处：《中华器官移植杂志》2012年第12期746-749,共4页Chinese Journal of Organ Transplantation

基　　金：国家自然科学基金（81170696）

摘　　要：目的探讨大鼠右侧供。肾移植中肾静脉的最佳吻合方式。方法以SD大鼠作为同系大鼠肾移植模型的供、受鼠，取45只供鼠的双侧。肾脏，采用随机数字表法将90只受鼠分为4组。A、B、C组受鼠各15只，均将右侧供肾移植于左侧肾窝，肾静脉的吻合方式分别采用端侧吻合、静脉搭桥、改进的端端吻合（供肾腔静脉近心端与受鼠。肾静脉端端吻合，结扎供肾腔静脉远心端）；对照组45只，均将左侧供肾移植于左侧肾窝，肾静脉的吻合方式采用传统的肾静脉端端吻合。对各组受鼠间的术中情况、手术成功率及术后并发症发生情况进行比较。结果B组肾静脉吻合时间显著长于其他3组（P〈0．05），由此导致B组的供肾热缺血时间和受鼠手术耗时也较其他3组显著延长（P〈0．05）。而A组和C组与对照组间的肾静脉吻合时间、供肾热缺血时间及受鼠手术耗时均无明显差异（P〉0．05）。C组手术成功率（93．3％）与对照组（86．7％）相当（P〉0．05），均显著高于A组（53．3％）和B组（53．3％）（P〈0．05）。C组与对照组间术后并发症的发生情况相当。结论大鼠右侧供肾移植中，截取部分腔静脉作为供肾静脉的一部分，将其近心端与受鼠肾静脉行端端吻合，并结扎其远心端，这种肾静脉的吻合方式可行性高，既高效又经济。Objective To explore the optimized method of venous anastomosis for right donor kidney transplantation in rats. Methods Sprague Dawley （SD） rats were used as donors and recipients for homologous rat kidney transplantation. Both bilateral kidneys were harvested from the donor rats （n = 45）. Ninety rats were used as recipients and divided into 4 groups according to randomly digital table.. In groups A- C （n = 15 each）, the right donor kidneys were transplanted into the left nephridial pit of recipients, and end- to-side, venous bypass and modified end-to-end （donor＇s proximal end of vena cava was anastomosed to recipients renal vein followed by ligation of its distal end） venous anastomosis was done, respectively; In the control group （n = 45）, the left donor kidneys were transplanted into the same side of the recipients, and the conventional end-tcrend venous anastomosis was used. Then the intra-operative findings, successful operation rate and postoperative complications were compared between two groups. Results The venous anastomosis time in group B was longer than in groups A, C and control group （P〈0. 05）, which significantly increased warm iscbemia time of donor kidneys and operative time of recipients （P〈0. 05）. The venous anastomosis time,warm ischemia time of donor kidneys and operative time of recipients showed no significant difference between groups A or C and control group （P〉0. 05）. The successful operation rate in group C （93. 3%） was similar to that in control group （86. 7%） （P〉0. 05） ,but higher than in group A （53. 3%） and group B （53. 3G） （P〈0. 05）. There was no significant difference in postoperative complications between group A and group （3. Conclusion For right donor kidney transplantation, the method of harvesting the right donor kidney with a part of vena cava, and then anastomosing the proximal end to recipients renal vein and ligating the distal end, is highly feasible, efficient and economic.

关 键 词：肾移植 大鼠 模型 动物 

分 类 号：R699.2[医药卫生—泌尿科学]