152例大鼠原位全小肠移植的外科技术总结.doc

152例大鼠原位全小肠移植的外科技术总结【摘要】目的总结大鼠原位全小肠移植的外科手术方法。方法雄性F344和LEWIS大鼠分别为供体和受体。供肠切取范围包括全小肠、门静脉及肠系膜上动脉。供肠肠系膜上动脉与受体肾下腹主动脉端侧吻合采用连续外翻锁边缝合方法，供体的门静脉与受体的左肾静脉端端吻合采用CUFF套管方法，切除受体自体小肠，断端与供体肠吻合重建消化道。供、受体术中均补液4～6ML。结果共进行152次移植手术，其中正式实验120次，供体手术时间6010MIN，受体手术时间10015MIN，移植肠热缺血时间305MIN，783大鼠术后存活超过2周，病理检查证实移植肠病变符合排斥反应特点。结论供肠获取、血管吻合术、术中血容量维持、保温是大鼠原位全小肠移植术的关键。【关键词】小肠移植；大鼠；移植排斥反应；微血管吻合ABSTRACTOBJECTIVETOREVIEWTHESURGICALTECHNIQUEFORORTHOTOPICSMALLBOWELTRANSPLANTATIONINRATSMETHODSTHEMALEF344ANDLEWISRATSWEREDONORSANDRECIPIENTS,RESPECTIVELYTHEENTIRESMALLBOWEL,PORTOLVEINANDSUPERIORMESENTERICARTERYWEREREMOVEDINTHEDONORSSMALLBOWELTRANSPLANTATIONSWEREPERFORMEDBYMICROVACULARENDTOSIDEANASTOMOSISOFTHEDONORSUPERIORMESENTERICARTERY,ANDTHERECIPIENTINFRARENALAORTABYCONTINUOUSLOCKSUTURETECHNIQUEANDBYFORMATIONOFA‘CUFF’ANASTOMOSISBETWEENTHEDONORPORTALVEINANDTHERECIPIENTLEFTRENALVEINTHESMALLBOWELOFTHERECIPIENTWASREMOVEDANDREPLACEDBYTHEGRAFTBOTHTHEDONORANDTHERECIPIENTRECEIVEDINTRAVENOUSADMINISTRATIONOF4～6MLOFLACTATEDRINGERSSOLUTION