摘要
目的 探讨脾皮下易位门体分流术在大鼠原位肝移植中的应用价值。方法 Wistar大鼠 180只 ,供、受体各 90只 ,供体体重略小于受体。受体鼠再随机分为脾皮下易位门体分流术 (STS)后原位肝移植 (OLT )组 (简称STS +OLT组 )和原位肝移植组 (简称OLT组 )。根据受体无肝期时间 ,又将上述两组分别分为A、B、C 3个亚组 (无肝期分别为 <2 5min、3 5min和 45min左右 ) ,每个亚组 15只。在无肝期前、后不同时相收集血标本 ,测定其ALT、内毒素及 pH值水平 ,并观察两组动物术后生存率。结果 在STS +OLT组 ,术后第 7d各亚组动物的ALT基本恢复到正常水平 ,而OLT组动物ALT水平于术后第 7d时仍明显增高 (P<0 .0 1) ,第 3 0d时才接近正常水平。STS +OLT组各亚组及OLTA组动物门静脉血中的 pH值及内毒素水平在无肝期前、后及再灌注 3 0min时差异均无显著性意义 (P >0 .0 5 ) ,而OLT组的B组和C组动物门脉血中pH值及内毒素水平在无肝期后及再灌注 3 0min时较无肝期明显增加 (P<0 .0 1)。OLT组动物术后各时间点生存率与STS +OLT组相比 ,除A组外 ,前者的B组和C组动物均明显低于后者的B组和C组(P<0 .0 1)。结论 脾皮下易位门体分流术可有效地防止因无肝期延长而引起的肝损害及门脉血中的pH值及内毒素增高 ,并能明显提高大鼠术?
Objective To evaluate the application of portosystemic shunt after subcutaneous transposition of the spleen (STS) to orthotopic liver transplantation (OLT) in the rat. Methods One hundred and eighty Wistar rats were randomly divided into the group of orthotopic liver transplantation after portosystemic shunts by subcutaneous transposition of the spleen (STS+OLT group) and the group of orthotopic liver transplantation (OLT group). The two groups were further divided into A, B, C subgroups in the light of duration of anhepatic phase (phases were respectively less than 25 min, around 35 min and 45 min).There were fifteen rats in each subgroup. At the described intervals, blood samples were collected from the peripheral and portal vein for testing ALT, pH and endotoxin levels. The survival rates were also observed. Results The ALT value of all animals basically returned to normal levels on the 7th postoperative day in the STS+OLT group and the OLT A subgroup, but in OLT B subgroup, ALT was still remarkably elevated on the 7th postoperative day ( P <0.01), and returned to normal levels on the 30th postoperative day. The pH values and endotoxin levels from the portal vein of all animals in STS+OLT groups and OLT A subgroup had no significant difference ( P >0.05) at the beginning, the end of the anhepatic phase and at the time of reperfusion for 30 min. But in the OLT B and C groups, the pH values and endotoxin levels were significantly higher at the end of anhepatic phase and reperfusion for 30 min than those in the beginning of anhepatic phase ( P <0.01). The survival rates at postoperative different time points in both B and C subgroup of the OLT group were significantly lower than those in STS+OLT group animals ( P <0.05).Conclusion The portosystemic shunt by subcutaneous transposition of the spleen can notably improve both the success rate of the OLT procedure and the postoperative survival rate in the rat.
出处
《中国普外基础与临床杂志》
CAS
2002年第4期224-227,共4页
Chinese Journal of Bases and Clinics In General Surgery
关键词
脾皮下易位门体分流术
原位肝移植
动物实验
STS
OLT
Subcutaneous transposition of the spleen Portosystemic shunt Orthotopic liver transplantation Rat
