大鼠肾移植模型四种肾静脉重建术式的比较  

Study on anastomosesing veins of renal allograft in rats

作　　者：李健[1] 许亚宏[1] 马小平[1] 张艮甫[2] 黄赤兵[2] 卢奕[1] 陈萍[1] 郭瑜[1] 

机构地区：[1]解放军第452医院泌尿外科,成都610021 [2]第三军医大学附属新桥医院泌尿外科

出　　处：《中华移植杂志（电子版）》2013年第4期21-24,共4页Chinese Journal of Transplantation(Electronic Edition)

摘　　要：目的探讨不同大鼠移植肾静脉重建术式的效果。方法建立大鼠同种异体肾移植模型,根据移植肾静脉重建方式不同将受体大鼠分为4组:32只实验组大鼠采用内支架法行原位端-端吻合;25只对照组Ⅰ大鼠采用原位端-端吻合;22只对照组Ⅱ大鼠采用Cuff管套扎法吻合;20只对照组Ⅲ大鼠采用受体下腔静脉端-侧吻合。比较各组大鼠移植肾静脉重建手术操作时间和静脉吻合口漏血、静脉血栓形成、静脉吻合口狭窄发生情况。结果实验组供肾静脉分离切取用时最短,为(9.1±0.9)min;对照组Ⅲ用时最长,为(12.1±0.9)min;两组比较差异有统计学意义(P<0.05)。实验组供肾静脉修整用时为(5.0±0.6)min,短于对照组Ⅱ和对照组Ⅲ,差异均有统计学意义(P均<0.05)。实验组移植肾静脉重建用时为(6.2±1.5)min,短于对照组Ⅰ和对照组Ⅲ,差异均有统计学意义(P均<0.05)。实验组术后静脉血栓发生率最低(3.1%),与对照组Ⅱ(27.3%)比较,差异有统计学意义(χ2=4.77,P<0.017);静脉吻合口狭窄发生率最低(3.1%),与对照组Ⅰ(24.0%)比较,差异有统计学意义(χ2=3.90,P<0.017)。结论应用内支架法行移植肾静脉原位端-端吻合操作时间短、并发症少,可有效解决大鼠肾移植静脉重建的问题。Objective To compare the difference in operation duration and occurrence of postoperative complications between four venous anastomosis techniques .Methods Male SD rats （8-10-week-old） served as both donors and recipients were used to construct allograft renal transplantation animal models .A total of 99 rats were divided into four groups according to the methods of venous anastomosis .32 allografts′veins were rebuild end-to-end in situ by way of endoprosthesises （ experiment group ）; As control group I , the allografts′veins were anastomosesed end-to-end in situ directly （n=25）.The allografts ′veins of control group II （n=22） were loop ligatured with cuff tubes before anastomosis .While the other 20 rats （ control group III ） were anastomosesed with recipients′inferior vena end-to-side.The operation time and complications of allografts′veins were observed . Results The time of harvesting donors′veins in the experiment group was significantly shorter than in control group III [（9.1 ±0.9） min vs （12.1 ±0.9） min, P〈0.05].Compared with the experiment group, the time using of veins chipping was significantly longer than the control group II [（5.0 ± 0.6） minvs （8.1 ±0.6） min, P〈0.05].The incidence of phlebothrombosis was higher in control group II than in the experiment group （χ2 =4.77, P〈0.05）.The incidence of stenostomatous in the experiment group was 3.1%, lower than the control group I （χ2 =3.90, P〈0.05）.Conclusion The end-to-end in situ with endoprosthesises of renal allograft can save the operation time and decrease the incidence of complications .

关 键 词：静脉重建 肾移植 大鼠 

分 类 号：R699.2[医药卫生—泌尿科学]