大鼠原位肝移植模型建立的学习曲线  

Learning curve of establishing rat orthotopic liver transplantation model

作　　者：林拥华[1] 陈志超 吴敏[1] 魏剑锋[1] Lin Yonghua;Chen Zhichao;Wu Min;Wei Jianfeng(Department of Hepatobiliary and Pancreatic Surgery,the Second Affiliated Hospital of Fujian Medical University,the Second Clinical Medical College of Fujian Medical University,Quanzhou 362000,China)

机构地区：[1]福建医科大学附属第二医院肝胆胰外科、福建医科大学第二临床学院,泉州362000

出　　处：《中华实验外科杂志》2023年第6期1188-1191,共4页Chinese Journal of Experimental Surgery

基　　金：福建省自然科学基金(2018J01286);福建医科大学启航基金(2020QH1119)。

摘　　要：目的:探讨建立稳定的大鼠原位肝移植模型的学习曲线。方法:采用成年雄性SD大鼠为供受体建立大鼠原位肝移植模型,手术方法以Kamada"二袖套法"为基础做适当改良。按时间顺序分成4个阶段:Ⅰ、Ⅱ、Ⅲ、Ⅳ。观察无肝期、手术成功率等,总结学习曲线。组间比较采用单因素方差分析,率的比较采用χ^(2)检验。结果:各阶段无肝期依次为(25.0±1.3)、(23.1±1.2)、(18.6±0.7)、(15.4±1.1)min,差异有统计学意义(F=471.005,P<0.05)。第Ⅰ、Ⅱ阶段的手术成功率分别为40%、70%,差异有统计学意义(χ^(2)=5.455,P<0.05);第Ⅱ、Ⅲ阶段手术成功率为70%、90%,差异无统计学意义(χ^(2)=1.071,P>0.05);第Ⅳ阶段手术成功率100%,与前面3个阶段比较差异均有统计学意义(χ^(2)=36.274、22.259、4.043,P<0.05)。结论:建立稳定的大鼠原位肝移植模型过程中,操作者一般会经历快速提升期到平台期(50~100例),可能是操作者处于"技术疲劳"的状态,随即进入成熟期。Objective To discuss the learning curve of establishing stable rat orthotopic liver transplantation model.Methods The rat orthotopic liver transplantation model was developed by modified Kamada"two-cuff method".Research process was divided into four stages includingⅠ,Ⅱ,ⅢandⅣ.The duration of major surgical procedures,anhepatic phase,success rate of operation,long-term survival rate of recipients,incidence of early and late complications were observed in each case to summarize the learning curve.One-way analysis of variance was used for comparison between stages,and Chi-square test was used for comparison of rates.Results The anhepatic phase of each stage successively was(25.0±1.3),(23.1±1.2),(18.6±0.7),(15.4±1.1)min,and the differences were statistically significant(F=471.005,P<0.05).The success rate of operation in stageⅠandⅡwas 40%and 70%,respectively,and the difference was statistically significant(χ^(2)=5.455,P<0.05).The success rate of operation in stageⅡandⅢincreased from 70%to 90%,and the difference was not statistically significant(χ^(2)=1.071,P>0.05).The success rate of operation in stageⅣwas stable at 100%,which was significantly different from the previous three stages(χ^(2)=36.274,22.259,4.043,P<0.05).Conclusion During the establishment of stable rat orthotopic liver transplantation model,operators generally experience a period of rapid improvement followed by plateau(between 50 and 100 cases),possibly resulting in a state of"technical fatigue",and then enter maturation stage.

关 键 词：肝移植 大鼠 动物模型 学习曲线 

分 类 号：R657.3[医药卫生—外科学] R-332[医药卫生—临床医学]