巴马小型猪心脏移植模型及供心保护策略  

Development of an animal model of heart transplantation in Bama miniature pigs and management of donor heart protection

作　　者：李斯林 孙煦勇 秦科[1] 李海滨 莫安胜[3] 侯善升 莫仁才 刘军 黎艳培 黄燕嫣 LI Si-lin;SUN Xu-yong;QIN Ke;LI Hai-bin;MO An-sheng;HOU Shan-sheng;MO Ren-cai;LIU Jun;LI Yan-pei;HUANG Yan-yan(Department of Organ Transplantation,the Second Affiliated Hospital of Guangxi Medical University,Nanning 530000,Guangxi,China)

机构地区：[1]广西医科大学第二附属医院器官移植科,广西南宁530007 [2]中国人民解放军联勤保障部队第九二三医院移植医学研究院,广西南宁530022 [3]广西中医药大学第一附属医院心胸血管外科,广西南宁530023

出　　处：《广东医学》2020年第4期332-335,共4页Guangdong Medical Journal

基　　金：国家自然科学基金面上项目(81670596);广西科学技术开发与研究项目(桂科攻14124003-8)。

摘　　要：目的总结和探讨本中心建立巴马小型猪心脏移植模型的经验及供心保护策略。方法选用25~35 kg的广西巴马小型猪各11头,分别作为供、受体。供体全麻下取胸部正中切口,主动脉根部4℃St.Thomas液灌停心脏,心脏离体后予UW液再次灌注并保存。受体采取全麻下正中切口,常规建立体外循环,采用双线对点交叉缝合的方式进行心房及大血管吻合。结果有8头移植心脏成功复跳,3头开放后出现室颤未能恢复自主心率,最初5头吻合口有活动性出血。结论巴马小型猪解剖结构有其特殊性,其心脏移植模型成功建立的关键在于合适的手术方式、合理的围手术期处理和恰当的心脏保存及心肌保护,本实验可为心脏移植的进一步基础和临床研究提供经验积累。Objective To review the development of a heart transplantation model in Bama miniature pigs and management of donor heart protection.Methods Eleven Guangxi Bama miniature pigs weighing 25~35 kg were selected as donors and another 11 as recipients.We chose chest median incision on the donor under general anesthesia,whose aorta root was irrigated with st.Thomas solution at 4℃to cardiac arrest.After the heart was isolated from the body,UW solution was re-perfused and the heart was preserved.The same incision was chosen on the recipient under general anesthesia.Routine cardiopulmonary bypass(CPB)was established and atrial and great vessels anastomosis was performed by double-thread cross-suture.Results There were 8 cases of successful transplantations and 3 cases of ventricular fibrillation afterthoracotomy leading to failure of restoring spontaneous heart rate.The first 5 cases developed active bleeding at the anastomotic site.Conclusion Bama miniature pigs has unique anatomical structures.The key to the successful establishment of its heart transplantation model lies in appropriate surgical technique mode,proper perioperative treatment,correct heart preservation and myocardial protection.This experiment can provide experience for further basic and clinical research of heart transplantation.

关 键 词：心脏移植 动物模型 手术方式 心脏保存 围手术期处理 心肌保护 

分 类 号：R617[医药卫生—外科学] Q95-3[医药卫生—临床医学]