大鼠小肠移植模型中血管吻合技术的探讨

Investigation of vascular anastomosis technique for small bowel transplantation model in rat

目的比较大鼠小肠移植中两种不同的血管吻合方法,改进吻合技术,提高大鼠小肠移植的成功率。方法雄性SD大鼠做供体,雄性Wistar大鼠做受体,建立大鼠异位小肠移植模型120例,分为对照组和实验组两组,每组60例,对照组采用经典两点固定双线连续缝合方法,实验组采用一点固定单线连续缝合方法,将供体腹主动脉、门静脉分别与受体腹主动脉、下腔静脉做端侧吻合。比较两组血管吻合时间、血管并发症及3天存活率的差异。结果对照组血管吻合总时间(53.42±4.16)分钟,实验组(42.31±3.72)分钟,实验组明显短于对照组(P<0.01);实验组吻合方法较对照组更易出血,但对照组误缝对侧的可能性更大,差异均有统计学意义(P<0.05和P<0.01);而两组吻合口并发症比较差异无统计学意义(P>0.05);对照组3天存活率为57.1%,实验组为78.9%,实验组显著高于对照组(P<0.05)。结论一点固定单线连续缝合法吻合时间明显缩短,不易发生对侧误缝,提高了小肠移植大鼠的生存率。

Objective To contrast two different types of vascular anastomosis for small bowel transplantation (SBT)in rat in order to improve survival rate of SBT. Method 120 SBT models were established which the donors and recipients were from SD and Wistar respectively. They were divided into two groups evenly(each n=60). The abdominal aorta and portal vein of the donors were end-to-side anastomosed with abdominal aorta and vena cava inferior of the recipients by continuous suture of two thread with two points fixed(control group)and continuous suture of single thread with one points fixed(experimental group). The time of vascular anastomosis,complication and 3-day survival rate were compared between two groups. Results The total time of vascular anastomosis were(53.42±4.16) minutes in control group and(42.31±3.72)minutes in experimental group(P<0.01). Bleeding was more likely to occur in experimental group,while error suture of the opposite side were more likely in control group(P<0.05 and P<0.01). There was no significance in anastomotic stoma complication between two groups(P>0.05). Survival rate on day 3 were 57.1% in control group and 78.9% in experimental group(P<0.05). Conclusion The time of vascular anastomosis by continuous suture of single thread with one points fixed was significantly reduced,which improved the survival rate of SBT in rat.