大鼠肝移植中veno-lined支架技术的改良研究  

Research of modified veno-lined stent technology in rats

作　　者：何宇涛 周焘 李晓凯[1] 董云 李望[1] 武睿超 张熙冰 郑克谱 冯世明 朱宏伟 李荻菲 冉江华[1] He Yutao;Zhou Tao;Li Xiaokai;Dong Yun;Li Wang;Wu Ruichao;Zhang Xibing;Zheng Kepu;Feng Shiming;Zhu Hongrwei;Li Difei;Ran Jianghua(Department of Hepatic biliary pancreatic&Vascular Surgery,Affiliated Calmete Hospital,Kunming Medical University,Kunming 650224,China)

机构地区：[1]昆明医科大学附属甘美医院,650224

出　　处：《中华器官移植杂志》2020年第11期687-691,共5页Chinese Journal of Organ Transplantation

基　　金：国家自然科学基金项目(81660112);云南省卫生科技计划项目(2016NS324)。

摘　　要：目的对veno-lined支架技术进行改良,探究一种更加快速简便且并发症少的大鼠原位肝移植(OLT)方法。方法利用改良的veno-lined支架技术对30对Wistar大鼠进行OLT。将制作好的veno-lined支架预先从供肝胸段的肝上下腔静脉(SHVC)切口处插入,到达膈肌下的SHVC后打结固定;在受体手术的无肝期,将带有供肝的veno-lined支架从受体肝脏左外侧叶根部切口处插入,到达膈肌以下后进行SHVC的吻合固定。记录各阶段的手术时长、手术成功率、7 d存活率和探讨术后SHVC有关的并发症。结果 SHVC吻合时长:(3.9±0.7)min;无肝期时长:(7.0±0.8)min;受体手术时长:(44.2±2.8)min;手术成功率:100%;7 d存活率:90%。SHVC出血、扭折、以及支架脱落等并发症并未出现;在veno-lined支架制作时和SHVC吻合固定时,通过规范打结线的固定位置,能够避免SHVC血栓形成。结论改良后的veno-lined支架技术,能将无肝期时长控制在7 min以内,是一种快速简便且并发症少的大鼠OLT方法。Objective To modify veno-lined stent technique for developing a faster and simpler method of orthotopic liver transplantation(OLT)with fewer complications in rats.Methods Thirty Wistar rats were employed for OLT by utilizing a modified veno-lined stent technology.A prepared veno-lined stent was pre inserted from an incision of suprahepatic vena cava(SHVC)in thoracic segment of donor liver.During anhepatic phase of recipient surgery,a veno-lined stent with donor liver was inserted through an incision at the root of left lateral lobe of recipient liver and reached below diaphragm for SHVC anastomosis and fixation.Operative duration at each stage,success rate of operation,survival rate at Day 7 and SHVC related complications were recorded.Results The duration of anastomosing SHVC was(3.9±0.7)min,anhepatic phase:(7.0±0.8)min,duration of recipient operation:(44.2±2.8)min,operative success rate:100%and survival rate at Day 7:90%.SHVC bleeding,torsion or stent distortion was not detected.SHVC thrombosis could be avoided by specifying the fixed position of silk suture during veno-lined stenting.Conclusions Designed to shorten anhepatic phase within 7 min,modified veno-lined stent technique is a quick and simple method of OLT in rats with fewer complications.

关 键 词：肝移植 大鼠 支架 

分 类 号：R657.3[医药卫生—外科学]