大鼠胰肠和胰膀胱重建式单纯胰腺移植模型的比较研究

Comparative study of the effects of pancreas transplantation models using enteric drainage and bladder drainage reconstruction methods in rats

目的 探讨大鼠单纯胰腺移植 (PTA )的不同手术方法的效果。方法 近交系SD大鼠为供、受体 ,分为正常对照组 (NDC组 ) 10只 ,糖尿病组 (DC组 ) 10只 ,胰肠重建式组 (E D组 )和胰膀胱重建式组 (B D组 )各 2 2只。血管吻合采用供胰腺腹主动脉绊 (含脾动脉 )和门静脉绊 (含脾静脉 )与受体腹主动脉及左肾静脉分别行端侧和端端吻合 (袖套式 )。并于术前和术后 1,3 ,7,14 ,3 0d监测受体体重、进食量、饮水量和空腹血糖。并分析失败原因。结果 E D组受体手术时间长于B D组 (P<0 .0 5 )。E D组除 11例 ( 5 0 % )、B D组除 12例 ( 5 4.3 % )于 1个月内死亡或胰腺失去功能外 ,其余动物均存活 1个月以上。E D组术后并发症主要为胰漏及继发性胰腺炎 ;B D组主要为尿路并发症 ,前者并发症发生率略低于后者。成功的PTA后受体第 1天血糖即下降 ,第 3天基本达到正常水平 ;饮水量、进食量、尿量均减少 ,14d后基本稳定。结论 成功的E D和B D重建式PTA均可有效地恢复糖尿病大鼠内分泌功能。

Objective To investigate the effect of pancreatic transplantion(PTA) using diverse operative (methods) in rats. Method Inbred SD rats were used as donor and recipient, and were randomly assigned (into) 4 groups:Normal control group( Group NC), consisted of 10 rats;diabetes group(Group DC) consisted of 10 rats;PTA with enteric drainage group(Group E-D), consisted of 22 diabetic rats;PTA using bladder reconstruction group(group B-D), consisted of 22 rats.Arterial supply of transplanted pancreas was (performed) by using end-to-side anastomosis of the donors' abdominal aorta(with splenic artery) and (recipients)′ abdominal aorta; and venous drainage was performed by using end-to-end anastomosis of the (donors)' portal vein segment(with splenic vein) and (recipients)′ left renal vein(cuff method). The fasting blood glucose, body weight, food intake, water intake and urine volume of the recipient were monitored before transplantation and on the 1st, 3rd, 7th, 14th, 30th day after operation, and also the reasons of failures were analyzed. Results The operative time of recipient in E-D group was significantly longer than that in B-D group(P<0.05). Eleven rats in group E-D(50.0%) and 12 rats in group B-D(54.5%) died or lost their pancreatic function within 1 month.The other rats survived.The main postoper\| ative complications in the group E-D were secondary pancreatitis and pancreas leak;and those of group B-D were urinary tract (complications). The complication rate of the former group was slightly lower than the latter group.(After) successful PTH,the recipients' blood glucose decreased on the first day after transplantation, and basically reached normal levels by day 3,and their food intake, water intake and urine volume decreased and became stable 14 days later. (Conclusions) Successful PTA with both the E-D and B-D can recover the pancreatic endocrine function of diabetic rats;the key to success of the (transplantation) is the prevention of posttransplantative complications .