CAJ | 학술논문

目的利用磁吻合技术,研制一套适用于离体肝切除术中快速建立静脉转流的装置,并实验测试其性能及临床应用价值.方法以钕铁硼永磁材料制成磁环,并将其与带有肝素涂层的高分子聚氯乙烯管道连接成"Y"形转流装置.10只实验犬模拟离体肝切除全过程.术中利用磁吻合技术完成静脉转流装置与静脉的吻合,建立体内静脉转流.记录转流建立的时间;彩色多普勒测定术前及术中各静脉血流速、计算转流量;检测术中无肝期血流动力学(颈动脉压、中心静脉压、门静脉压)以及肠管、肾组织变化.结果术中用静脉转流装置在6 ～ 10 min内即可建立静脉转流,无肝期动物血流动力学稳定,术前静脉流速与术中静脉流速比较无统计学差异(P＞0.05),门静脉和下腔静脉转流率分别为75.5％和76.2％,明显减轻内脏淤血.结论采用磁吻合技术可明显缩短离体肝切除术中静脉转流建立所需时间.动物实验证明快速静脉转流装置在无肝期可有效进行静脉转流,维持血液动力学稳定.
목적 이용자문합기술,연제일투괄용우리체간절제술중쾌속건립정맥전류적장치,병실험측시기성능급림상응용개치.방법 이녀철붕영자재료제성자배,병장기여대유간소도층적고분자취록을희관도련접성"Y"형전류장치.10지실험견모의리체간절제전과정.술중이용자문합기술완성정맥전류장치여정맥적문합,건입체내정맥전류.기록전류건립적시간;채색다보륵측정술전급술중각정맥혈류속、계산전류량;검측술중무간기혈류동역학(경동맥압、중심정맥압、문정맥압)이급장관、신조직변화.결과 술중용정맥전류장치재6 ～ 10 min내즉가건립정맥전류,무간기동물혈류동역학은정,술전정맥류속여술중정맥류속비교무통계학차이(P＞0.05),문정맥화하강정맥전류솔분별위75.5％화76.2％,명현감경내장어혈.결론 채용자문합기술가명현축단리체간절제술중정맥전류건립소수시간.동물실험증명쾌속정맥전류장치재무간기가유효진행정맥전류,유지혈액동역학은정.
Objective To invent a set of novel veno-venous bypass (VVB) device based on magnetic anastomosis technique which can be used in ex situ liver resection, and verify its clinical value and performance in animal models.Methods Each VVB device was constructed using three magnetic rings and an inverted Y-shaped tube with magnetic rings on each end.The magnetic ring was made of NdFeB with electrode cutting, and the tube was made of polyvinyl chloride (PVC) and preconditioned with heparin coating on the surface of the lumen.Ten dogs underwent the ex situ liver resection, and VVB was established via magnetic anastomosis technique with the novel VVB device during the operation.The time for completing VVB was recorded, and the hemodynamic indexes including the venous flow velocity, carotid pressure, central venous pressure and portal pressure was detected.The changes of intestinal lumen and kidney were also observed.Results It only took 6 ～ 10 minutes to establish VVB by the novel VVB device in the operation,and the hemodynamics stability was maintained smoothly during the anheptic phase.The shunt index of inferior vena cava and portal vein was 76.2％ and 75.5％, respectively.The congestion of intestinal canal and kidney were also alleviated during the anheptic phase.Conclusions It could reduce the time to establish VVB with magnetic anastomosis technique in ex situ liver resection.This study showed that utilizing the novel VVB device for intraabdominal VVB during the anheptic phase could be helpful to maintain the hemodynamics stability.