中华器官移植杂志
中華器官移植雜誌
중화기관이식잡지
CHINESE JOURNAL OF ORGAN TRANSPLANTATION
2012年
12期
746-749
,共4页
邓新军%刘永光%郭颖%李民%岳良升%范礼佩%陈桦%张建强%魏亚非%何敏毅%赵明
鄧新軍%劉永光%郭穎%李民%嶽良升%範禮珮%陳樺%張建彊%魏亞非%何敏毅%趙明
산신군%류영광%곽영%리민%악량승%범례패%진화%장건강%위아비%하민의%조명
肾移植%大鼠%模型,动物
腎移植%大鼠%模型,動物
신이식%대서%모형,동물
Kidney transplantation%Rats%Model,animal
目的 探讨大鼠右侧供肾移植中肾静脉的最佳吻合方式.方法 以SD大鼠作为同系大鼠肾移植模型的供、受鼠,取45只供鼠的双侧肾脏,采用随机数字表法将90只受鼠分为4组.A、B、C组受鼠各15只,均将右侧供肾移植于左侧肾窝,肾静脉的吻合方式分别采用端侧吻合、静脉搭桥、改进的端端吻合(供肾腔静脉近心端与受鼠肾静脉端端吻合,结扎供肾腔静脉远心端)；对照组45只,均将左侧供肾移植于左侧肾窝,肾静脉的吻合方式采用传统的肾静脉端端吻合.对各组受鼠间的术中情况、手术成功率及术后并发症发生情况进行比较.结果 B组肾静脉吻合时间显著长于其他3组(P＜0.05),由此导致B组的供肾热缺血时间和受鼠手术耗时也较其他3组显著延长(P＜0.05).而A组和C组与对照组间的肾静脉吻合时间、供肾热缺血时间及受鼠手术耗时均无明显差异(P＞0.05).C组手术成功率(93.3％)与对照组(86.7％)相当(P＞0.05),均显著高于A组(53.3％)和B组(53.3％)(P＜0.05).C组与对照组间术后并发症的发生情况相当.结论 大鼠右侧供肾移植中,截取部分腔静脉作为供肾静脉的一部分,将其近心端与受鼠肾静脉行端端吻合,并结扎其远心端,这种肾静脉的吻合方式可行性高,既高效又经济.
目的 探討大鼠右側供腎移植中腎靜脈的最佳吻閤方式.方法 以SD大鼠作為同繫大鼠腎移植模型的供、受鼠,取45隻供鼠的雙側腎髒,採用隨機數字錶法將90隻受鼠分為4組.A、B、C組受鼠各15隻,均將右側供腎移植于左側腎窩,腎靜脈的吻閤方式分彆採用耑側吻閤、靜脈搭橋、改進的耑耑吻閤(供腎腔靜脈近心耑與受鼠腎靜脈耑耑吻閤,結扎供腎腔靜脈遠心耑)；對照組45隻,均將左側供腎移植于左側腎窩,腎靜脈的吻閤方式採用傳統的腎靜脈耑耑吻閤.對各組受鼠間的術中情況、手術成功率及術後併髮癥髮生情況進行比較.結果 B組腎靜脈吻閤時間顯著長于其他3組(P＜0.05),由此導緻B組的供腎熱缺血時間和受鼠手術耗時也較其他3組顯著延長(P＜0.05).而A組和C組與對照組間的腎靜脈吻閤時間、供腎熱缺血時間及受鼠手術耗時均無明顯差異(P＞0.05).C組手術成功率(93.3％)與對照組(86.7％)相噹(P＞0.05),均顯著高于A組(53.3％)和B組(53.3％)(P＜0.05).C組與對照組間術後併髮癥的髮生情況相噹.結論 大鼠右側供腎移植中,截取部分腔靜脈作為供腎靜脈的一部分,將其近心耑與受鼠腎靜脈行耑耑吻閤,併結扎其遠心耑,這種腎靜脈的吻閤方式可行性高,既高效又經濟.
목적 탐토대서우측공신이식중신정맥적최가문합방식.방법 이SD대서작위동계대서신이식모형적공、수서,취45지공서적쌍측신장,채용수궤수자표법장90지수서분위4조.A、B、C조수서각15지,균장우측공신이식우좌측신와,신정맥적문합방식분별채용단측문합、정맥탑교、개진적단단문합(공신강정맥근심단여수서신정맥단단문합,결찰공신강정맥원심단)；대조조45지,균장좌측공신이식우좌측신와,신정맥적문합방식채용전통적신정맥단단문합.대각조수서간적술중정황、수술성공솔급술후병발증발생정황진행비교.결과 B조신정맥문합시간현저장우기타3조(P＜0.05),유차도치B조적공신열결혈시간화수서수술모시야교기타3조현저연장(P＜0.05).이A조화C조여대조조간적신정맥문합시간、공신열결혈시간급수서수술모시균무명현차이(P＞0.05).C조수술성공솔(93.3％)여대조조(86.7％)상당(P＞0.05),균현저고우A조(53.3％)화B조(53.3％)(P＜0.05).C조여대조조간술후병발증적발생정황상당.결론 대서우측공신이식중,절취부분강정맥작위공신정맥적일부분,장기근심단여수서신정맥행단단문합,병결찰기원심단,저충신정맥적문합방식가행성고,기고효우경제.
Objective To explore the optimized method of venous anastomosis for right donor kidney transplantation in rats.Methods Sprague Dawley (SD) rats were used as donors and recipients for homologous rat kidney transplantation.Both bilateral kidneys were harvested from the donor rats (n =45).Ninety rats were used as recipients and divided into 4 groups according to randomly digital table:In groups AC (n =15 each),the right donor kidneys were transplanted into the left nephridial pit of recipients,and endto-side,venous bypass and modified end-toend (donor's proximal end of vena cava was anastomosed to recipients renal Vein followed by ligation of its distal end) venous anastomosis was done,respectively; In the control group (n =45),the left donor kidneys were transplanted into the same side of the recipients,and the conventional end-to-end venous anastomosis was used.Then the intra-operative findings,successful operation rate and postoperative complications were compared between two groups.Results The venous anastomosis time in group B was longer than in groups A,C and control group (P＜0.05),which significantly increased warm ischemia time of donor kidneys and operative time of recipients (P＜0.05).The venous anastomosis time,warm ischemia time of donor kidneys and operative time of recipients showed no significant difference between groups A or C and control group (P＞0.05).The successful operation rate in group C (93.3％)was similar to that in control group (86.7％) (P＞0.05),but higher than in group A (53.3％) and group B (53.3％) (P＜0.05).There was no significant difference in postoperative complications between group A and group C.Conclusion For right donor kidney transplantation,the method of harvesting the right donor kidney with a part of vena cava,and then anastomosing the proximal end to recipients renal vein and ligating the distal end,is highly feasible,efficient and economic.
