大鼠肝移植肝上下腔静脉不同缝合方式及手术体会  

Different Suture Technique of Suprahepatic Vena Cava and Corresponding Surgical Experience in Rat Liver Transplantation

作　　者：沃琪 任咪 李蕾 黄勇 方旭[3] 徐军明[1] 张金彦[1] WO Qi;REN Mi;LI Lei;HUANG Yong;FANG Xu;XU Jun-min;ZHANG Jin-yan(Department of General Surgery,Shanghai General Hospital Shanghai Jiao Tong University School of Medicine,Shanghai,200080,China;Department of Anesthesiology,Zhongshan Hospital,Fudan University School of Medicine,Shanghai,200030,China;Department of General Surgery,Shanghai Yangpu Hospital,Tongji University,Shanghai,200082,China)

机构地区：[1]上海交通大学附属上海市第一人民医院普外科,上海200080 [2]复旦大学附属中山医院麻醉科,上海200030 [3]同济大学附属上海市杨浦区中心医院普外科,上海200082

出　　处：《现代生物医学进展》2021年第4期609-613,共5页Progress in Modern Biomedicine

基　　金：国家自然科学基金面上项目(81670595);上海市科委基金项目(15411967200)。

摘　　要：目的:探讨肝上下腔静脉不同缝合方式对大鼠原位肝移植的影响。方法:选取雄性SD大鼠60对,以SD大鼠为供体和受体,随机分成A、B两组,每组30对。两组均采用改良Kamada"二袖套法"进行大鼠原位肝移植,A组采用双定点连续缝合方式吻合肝上下腔静脉,B组采用单定点连续缝合方式吻合。比较两组肝上下腔静脉吻合时长、无肝期时长以及术后并发症及存活率等情况。结果:A组供体取肝、修肝、无肝期、肝上下腔静脉(SHVC)吻合时长分别为28.5(27.0-31.1)min、9.5(9.0-10.6)min、20.6±1.3 min、8.5(8.0-9.0)min,B组分别为30.0(27.8-32.0)min、9.0(8.6-10.0)min、18.1±1.4 min、7.0(6.5-7.4)min,其中两组的无肝期、SHVC吻合时长具有统计学差异(P<0.05)。A组SHVC吻合口出血4/30例、其他并发症6/30例,B组吻合口出血1/30例、其他并发症5/30例,术后2天以及术后2周存活率以及术后并发症方面,两组均无显著差异(P>0.05)。结论:单定点连续缝合SHVC比双定点连续缝合更有效地缩短无肝期时长,并降低开放后吻合口漏血发生几率,两种吻合方式均能成功建立稳定可行的大鼠肝移植模型。Objective:To investigate the effects of different suture technique of suprahepatic vena cava(SHVC)reconstruction on rat orthotopic liver transplantation(ROLT).Methods:Sixty pairs of male SD rats were randomly selected as donors and recipients.According to the random number table,the rats were equally divided into group A and group B.The modified Kamada"two-cuff"technique was used to ROLT for the both two groups.In group A,double-point running suture was taken to anastomose SHVC,while single-point running suture was adopted in group B.The SHVC reconstruction time,anhepatic time,postoperative complications and survival were compared between the two groups.Results:The donors’operation time(DOT),cuffing time(CT),anhepatic phase(AP),SHVC reconstruction time(SHVCRT)in group A were respectively 28.5(27.0-31.1)min,9.5(9.0-10.6)min,20.6±1.3 min,8.5(8.0-9.0)min,and the data in group B were respectively 30.0(27.8-32.0)min,9.0(8.6-10.0)min,18.1±1.4 min,7.0(6.5-7.4)min.There were statistical differences on AH and SHVCRT between the two groups(P<0.05).Anastomotic hemorrhage(AH)of SHVC in group A was 4/30 cases,and other complications were 6/30 cases,Of which in group B were respectively 1/30 cases and 5/30 cases(P>0.05).There were no significant differences in two-day and two-week survival rate and postoperative complications between the two groups(P>0.05).Conclusions:The single-point running suture could apparently shorten the anhepatic phase and reduce the incidence of anastomotic hemorrhage,and both anastomosis technique are proved to be reliable and feasible on ROLT.

关 键 词：肝上下腔静脉吻合 肝移植 大鼠 异常解剖 

分 类 号：R-33[医药卫生] R657.3