双泵双氧合机械灌注设备应用于热缺血损伤猪肝脏低温灌注的可行性研究  

Feasibility study of dual-pump and dual-oxygenator mechanical perfusion device for hypothermic perfusion of liver in pig with thermal ischemic injury

作　　者：何锡然 谭晓宇 张琳 刘华敏 邝伟键 梁铭炬 周伟津 郭家钘 陈素平 霍枫 HE Xi-ran;TAN Xiao-yu;ZHANG Lin;LIU Hua-min;KUANG Wei-jian;LIANG Ming-ju;ZHOU Wei-jin;GUO Jia-xing;CHEN Su-ping;HUO Feng(Department of Biomedical Sciences,Guangdong Shunde Industry Design Institute(Guangdong Shunde Innovative Design Institute),Foshan 528311,Guangdong Province,China;Department of Hepatobiliary Surgery,General Hospital of Southern Theater Command,Guangzhou 510010,China;Department of Research and Development,Guangdong Devocean Medical Instrument Co.,Ltd.,Foshan 528311,Guangdong Province,China)

机构地区：[1]广东顺德工业设计研究院(广东顺德创新设计研究院)生物医学部,广东佛山528311 [2]南部战区总医院肝胆外科,广州510010 [3]广东丁沃生医疗器械有限公司研发部,广东佛山528311

出　　处：《医疗卫生装备》2021年第3期6-11,共6页Chinese Medical Equipment Journal

基　　金：国家青年科学基金项目(81800556);军队实验动物专项科研项目(SYDW(2017)12);佛山顺德区重大科技计划项目(顺府办函[2019]42号)。

摘　　要：目的:初步探索离体肝脏双泵双氧合机械灌注设备在离体猪肝脏低温灌注中的可操作性以及稳定性。方法:从45~50 kg雌性巴马小型猪获取供肝,利用灌注设备同时对肝动脉和门静脉实施低温携氧灌注8 h。肝动脉采用压力恒定模式控制,门静脉采用流量恒定模式控制,观察灌注过程中的流量、压力、血气指标、炎症因子以及病理组织学评分的变化。采用IBM SPSS Statistics 23.0统计学软件进行实验数据分析。结果:灌注过程中,肝动脉压力稳定维持在24.09~24.65 mmHg(1 mmHg=133.32 Pa),流量从初期的0.04 mL/[min·g(肝重)]逐渐升高至0.09 mL/[min·g(肝重)];门静脉的流量稳定维持在0.47~0.50 mL/[min·g(肝重)],压力呈降低趋势,从初期的2.79 mmHg下降至1.84 mmHg。灌注液pH值、葡萄糖(Glu)以及乳酸(Lac)水平维持稳定。肝组织的炎症因子白介素6(IL-6)和肿瘤坏死因子α(TNF-α)亦维持稳定。在组织病理学评价方面,肝组织的空泡化水平呈下降趋势,而肝组织的坏死、水肿以及肝窦扩张水平则维持稳定。结论:该离体肝脏双泵双氧合机械灌注设备能够无故障地运转8 h,同时维持肝脏的低代谢状态,降低肝内灌注阻力和改善肝细胞缺氧,具有安全性和稳定性。Objective To explore the operability and stability of an isolated liver mechanical perfusion device with dual-pump and dual-oxygenator in hypothermic perfusion of isolated pig liver.Methods Livers from female Bama minipigs weighed 45 to 50 kg had their hepatic arteries and portal veins undergoing 8 h hypothermic oxygenated perfusion.The hepatic arteries had the perfusion with constant pressure,while the portal veins had the perfusion with constant flow.Changes in flow,pressure,blood gas indicators,inflammatory factors and histopathological scores were observed during perfusion.IBM SPSS Statistics 23.0 software was used to analyze the experimental data.Results During perfusion,the hepatic artery pressure was maintained at a stable level of 24.09 to 24.65 mmHg(1 mmHg=133.32 Pa),and the flow gradually increased from 0.04 mL/[min·g(liver weight)]at the beginning to 0.09 mL/[min·g(liver weight)];the flow in the portal vein was maintained at a stable level of 0.47 to 0.50 mL/[min·g(liver weight)],while the pressure decreased from 2.79 mmHg initially to 1.84 mmHg.Perfusion fluid pH,glucose(Glu)and lactate(Lac)levels as well as the inflammatory factors IL-6 and TNF-αin the liver tissue were kept stable.In terms of histopathological evaluation,the level of vacuolation in liver tissue tended to decrease,while the level of necrosis,oedema and sinusoidal dilatation in liver tissue remained stable.Conclusion The isolated liver mechanical perfusion device with dual-pump and dual-oxygenator has an 8 h trouble-free running time and high safety and stability,while maintaining a hypometabolic state in the liver,reducing intrahepatic perfusion resistance and improving hepatocyte hypoxia.

关 键 词：低温机械灌注 机械灌注设备 离体肝脏 肝脏保存 肝移植 DEVOCEAN-LIVER 2000 

分 类 号：R318[医药卫生—生物医学工程] R657.3[医药卫生—基础医学]