实验犬原位肝移植术中静脉-静脉转流时腹主动脉阻断的意义

Beneficial effects of abdominal aorta block on the heamodynamic stability of the dog undergoing orthotopic liver transplantation with veno-venous bypass

目的 通过对实验犬原位肝移植的麻醉及管理 ,为临床开展人体肝移植做准备 ;观察无肝期两种不同处理方法对实验犬的血流动力学及实验成功率的影响。方法 2 4只健康犬被分为供体组和受体组 ,均肌肉注射氯胺酮、氯丙嗪 ,入睡后保留自主呼吸行气管插管 ,受体犬行前肢动脉穿刺以监测平均动脉压及心率。在无肝期将受体犬分成 2组 :Ⅰ组仅行静脉- 静脉转流 ,Ⅱ组做静脉 - 静脉转流的同时阻断腹主动脉。结果 两组受体犬在诱导后、病肝切除期血流动力学指标差异无显著性意义 (P >0 . 0 5 )。在无肝期、新肝期及术毕血流动力学指标差异有显著性意义 (P <0. 0 5 )。结论 无肝期行静脉 - 静脉转流的同时阻断腹主动脉有助于实验犬的血流动力学稳定 ,提高了动物实验的成功率。

Objective To investigate the heamodynamic changes during orthotopic liver transplantation with veno-venous bypass in the dog, and to evaluate the beneficial effects of abdominal aorta block in the anhepatic phase.Methods Of the 12 canine liver transplants performed under general anesthesia in this study, there were two groups: the control group(group I), i.e. orthotopic liver transplantation with veno-venous bypass; and the experimental group(group II),where the abdominal aorta was blocked in the anhepatic phase during orthotopic liver transplantation with veno-venous bypass. The date of heart rate and mean arterial blood pressure were measured at following occasion: after intubation, dissection phase, anhepatic phase, reperfusion phase and the end of operation.Results There was no significant difference in the hemodynamic changes between the two groups before anhepatic phase (P>0.05),but in the anhepatic phase and reperfusion phase, the hemodynamic data were more stable in group II than group I (P<0.05).Conclusion The use of abdominal aorta block in the anhepatic phase can be a valuable alternative treatment for heamodynamic stability during orthotopic liver transplantation with veno-venous bypass. Accordingly it will meliorate the successful rate of the operation.