CAJ | 학술논문

目的：探讨不同大鼠移植肾静脉重建术式的效果。方法建立大鼠同种异体肾移植模型，根据移植肾静脉重建方式不同将受体大鼠分为4组：32只实验组大鼠采用内支架法行原位端-端吻合；25只对照组Ⅰ大鼠采用原位端-端吻合；22只对照组Ⅱ大鼠采用Cuff管套扎法吻合；20只对照组Ⅲ大鼠采用受体下腔静脉端-侧吻合。比较各组大鼠移植肾静脉重建手术操作时间和静脉吻合口漏血、静脉血栓形成、静脉吻合口狭窄发生情况。结果实验组供肾静脉分离切取用时最短，为（9．1±0．9） min；对照组Ⅲ用时最长，为（12．1±0．9）min；两组比较差异有统计学意义（P＜0．05）。实验组供肾静脉修整用时为（5．0±0．6）min，短于对照组Ⅱ和对照组Ⅲ，差异均有统计学意义（P均＜0．05）。实验组移植肾静脉重建用时为（6．2±1.5） min，短于对照组Ⅰ和对照组Ⅲ，差异均有统计学意义（P均＜0．05）。实验组术后静脉血栓发生率最低（3．1％），与对照组Ⅱ（27．3％）比较，差异有统计学意义（χ2＝4．77， P＜0．017）；静脉吻合口狭窄发生率最低（3．1％），与对照组Ⅰ（24．0％）比较，差异有统计学意义（χ2＝3．90， P＜0．017）。结论应用内支架法行移植肾静脉原位端-端吻合操作时间短、并发症少，可有效解决大鼠肾移植静脉重建的问题。
목적：탐토불동대서이식신정맥중건술식적효과。방법건립대서동충이체신이식모형，근거이식신정맥중건방식불동장수체대서분위4조：32지실험조대서채용내지가법행원위단-단문합；25지대조조Ⅰ대서채용원위단-단문합；22지대조조Ⅱ대서채용Cuff관투찰법문합；20지대조조Ⅲ대서채용수체하강정맥단-측문합。비교각조대서이식신정맥중건수술조작시간화정맥문합구루혈、정맥혈전형성、정맥문합구협착발생정황。결과실험조공신정맥분리절취용시최단，위（9．1±0．9） min；대조조Ⅲ용시최장，위（12．1±0．9）min；량조비교차이유통계학의의（P＜0．05）。실험조공신정맥수정용시위（5．0±0．6）min，단우대조조Ⅱ화대조조Ⅲ，차이균유통계학의의（P균＜0．05）。실험조이식신정맥중건용시위（6．2±1.5） min，단우대조조Ⅰ화대조조Ⅲ，차이균유통계학의의（P균＜0．05）。실험조술후정맥혈전발생솔최저（3．1％），여대조조Ⅱ（27．3％）비교，차이유통계학의의（χ2＝4．77， P＜0．017）；정맥문합구협착발생솔최저（3．1％），여대조조Ⅰ（24．0％）비교，차이유통계학의의（χ2＝3．90， P＜0．017）。결론응용내지가법행이식신정맥원위단-단문합조작시간단、병발증소，가유효해결대서신이식정맥중건적문제。
Objective To compare the difference in operation duration and occurrence of postoperative complications between four venous anastomosis techniques .Methods Male SD rats (8-10-week-old) served as both donors and recipients were used to construct allograft renal transplantation animal models .A total of 99 rats were divided into four groups according to the methods of venous anastomosis .32 allografts′veins were rebuild end-to-end in situ by way of endoprosthesises ( experiment group ); As control group I , the allografts′veins were anastomosesed end-to-end in situ directly (n=25).The allografts ′veins of control group II (n=22) were loop ligatured with cuff tubes before anastomosis .While the other 20 rats ( control group III ) were anastomosesed with recipients′inferior vena end-to-side.The operation time and complications of allografts′veins were observed . Results The time of harvesting donors′veins in the experiment group was significantly shorter than in control group III [(9.1 ±0.9) min vs (12.1 ±0.9) min, P<0.05].Compared with the experiment group, the time using of veins chipping was significantly longer than the control group II [(5.0 ± 0.6) minvs (8.1 ±0.6) min, P<0.05].The incidence of phlebothrombosis was higher in control group II than in the experiment group (χ2 =4.77, P<0.05).The incidence of stenostomatous in the experiment group was 3.1%, lower than the control group I (χ2 =3.90, P<0.05).Conclusion The end-to-end in situ with endoprosthesises of renal allograft can save the operation time and decrease the incidence of complications .