摘要
目的 建立一种新肝肠联合移植手术模型,探讨移植肝脏对移植小肠的保护作用.方法Wistar大鼠同种异体肝肠联合移植,供体手术时门静脉和肠系模上动脉进行双重冷灌注,用冷新霉素液冲洗小肠肠腔并清洁.受体手术的先进行肝脏移植,再进行小肠移植,门静脉、肝下下腔静脉袖套式吻合,肠系膜上动脉在显微镜下与左肾动脉油套式吻合,供体肠系膜上静脉袖套式与受体左肾静脉吻合,回肠下端在左下腹部造□,完成肝肠联合移植.结果 手术成功率为62.5%(15/24),手术平均存活为11.2天.手术后组织学发现:移植肝脏和小肠发生排斥反应.结论(1)袖套式血管吻合技术在大鼠身上建立的肝肠联合移植模型是可行的.(2)肝肠联合移植后移植的肝脏不能起到保护移植小肠的作用.
Objective:To established a new model of combined liver and small intestinal transplantation in rat and to probe into the action that grafted liver protect the grafted small intestine. Methods: The donor operation: the portal vein and superior mesente ric artery were flushed with 4℃ cold Riger's solution. The small intestinal lumen was flushed with 4℃ cold neomycin solution. The donor small intestine and liver were taken out respectively. The recipient operation:the orthotopic liver transplantation was at first grafted. Then the small intestinal transplantation was carried out. The suprahepatic SVC was anastomosed end to end to the recipient. The donor portal vein and the inferior hepatic IVC was anastomosed by the means of the cuff method. The donor superior mesente ric artery was anastomosed end to end to the recipient left renal artery under microscope. The donor superior mesenteric vein was anastomosed to recipient left renal vein by means of the cuff method. The lower ileum was exteriorized as stoma in left lower abdomen. Results:The operation successful rate was 62.5%. The grafted rats time survival was 11. 2% days. The rejection immediately occured after operation. The grafted small intestine showed bleed and necrosis. The grafted liver also showed rejection. Conclusion: (1)lt is feasible to established a model of simultaneous liver and small intestine transplantation by means of cuff fashion. (2)The acute rejection occured postgraft. The grafted liver didn't protect the grafted small intestine from the acute rejection.
出处
《中国现代普通外科进展》
CAS
1999年第4期23-25,共3页
Chinese Journal of Current Advances in General Surgery
