摘要
目的：建立静脉转流辅助的猪自体肝移植模型，研究自体肝移植过程中肝脏静态冷保存的方法，为临床自体肝移植静脉转流以及肝脏机械灌注提供实验基础。方法取长白猪5头，分别经颈内静脉、脾静脉及股静脉插管建立门静脉-体静脉转流通道，以4℃ UW液经肝动脉、门静脉原位低温灌注、保存肝脏2h。监测生命体征及手术预后，检测不同时间点转氨酶、胆红素、白蛋白等肝功能指标的变化。结果手术过程中，动物生命体征平稳，肝脏灌注良好。血流复灌后肝脏血供可。术后动物存活时间均达120 h以上。丙氨酸氨基转移酶和天冬氨酸氨基转移酶水平在开放血流24 h达峰值，分别为（69．8±16．2）U／L和（457．7±50．1）U／L，于开放96 h恢复正常范围。血清总胆红素水平于开放48 h达峰值[（7．1±3．3）μmol／L]，以后迅速下降。血浆白蛋白在肝脏恢复血供后迅速下降，4 h达最低点[（11．1±2．7）g／L]，16 h以后平稳回升至正常范围。结论猪自体肝移植术中有效静脉转流有助于维持术中生命体征平稳，保障术后存活率。该模型的建立为肝脏的保存及修复方式提供了实验基础。
Objective To establish the vein bypass assisted porcine liver auto transplantation model and study the methods of liver cold storage during the operation , in order to provide experience for the clini-cal application of liver auto transplantation and experimental evidence for liver machine perfusion .Methods A total of 5 pigs were operated to establish the portal-vein bypass by inserting cannula into vena jugularis in-terna, femoral vein and splenic vein , with liver being hypothermic perfused and stored in situ by 4℃ UW solution through hepatic artery and portal vein .Vital signs and clinical outcomes were monitored during the operation, and the changes of liver function indexes such as aminotransferase , total bilirubin and albumin were detected at different time points .Results During the operation , the vital signs kept steady and liver were perfused well , achieving fully blood supply after reperfusion .All animals survived over 120 h.Both al-anine aminotransferase and aspartate transaminase peaked at 24 h after blood reperfusion （69.8 ±16.2 U/L and 457.7 ±50.1 U/L）, and then dropped within normal range at 96 ho after reperfusion.Total bilirubin peaked at 48 h after blood reperfusion （7.1 ±3.3μmol/L）, and then decreased rapidly .The plasma albu-min kept falling after blood reperfusion , reaching the minimum of 11.1 ±2.7 g/L at 4 h after reperfusion, and then rose to normal level steadily at 16 h.Conclusions The vein bypass assisted liver auto transplanta-tion could guarantee the steady vital signs and survival rate , which may supply an experimental basis for de-veloping new efficient liver preservation and restoration methods .
出处
《中华肝胆外科杂志》
CAS
CSCD
北大核心
2016年第6期407-411,共5页
Chinese Journal of Hepatobiliary Surgery
基金
国家自然科学基金委员会一新疆联合基金重点支持项目（U1403222）
关键词
自体肝移植
转流
动物模型
Liver auto transplantation
Bypass
Animal model
