构建工作型大鼠异位心脏模型的实验

Construction of working cardiac transplant model in rats

目的:建立工作型大鼠腹部异位心脏移植模型,探讨模型建立手术并发症的原因及预防措施,为进一步研究心脏移植奠定基础。方法:实验于2004-07/2005-01在解放军南京军区南京总医院动物实验科完成。供心完全停跳后,下腔和上腔静脉分别结扎离断,切断主、肺动脉,切开左心耳,供心肺动脉与左房端侧吻合,钝性游离出腹主动脉和下腔静脉并阻断,供心主动脉与受体腹主动脉连续缝合,左室血液经供心主动脉吻合口进入受体腹主动脉,从而模型的左右心室均有输出功能,进行预实验96只,正式实验20只。结果:116只SD大鼠纳入结果分析。①预实验96只和正式实验20只手术成功率分别为56%和90%。预实验中并发症的发生率为43.8%,主要并发症包括麻醉意外、吻合口出血及狭窄、截瘫、供心保护不良、休克、内环境紊乱、术后早期供心失活。正式实验中并发症的发生率为10%。②吸氧状态下,吻合口前后的氧分压分别为(20.4±1.9),(11.2±1.3)kPa,差异极显著(P<0.01);未吸氧状态下吻合口前后的氧分压分别为(9.9±1.2),(6.7±1.2)kPa,差异极显著(P<0.01),吸氧后吻合口前氧分压较未吸氧明显升高(P<0.01)。结论:针对手术相关并发症的发生原因进行预防、处理,可使工作型大鼠腹部异位心脏移植模型达到稳定的高成功率。

AIM： To establish abdominal working cardiac transplant models in rats, and investigate the reasons and preventive measures of perioperative complications, so as to lay a foundation for the further study of heart transplantation. METHODS： The experiment was carried out in the animal experimental department of the Nanjing General Hospital of Nanjing Military Area Command of Chinese PLA between July 2004 and January 2005. Heterotopic hearts were transplanted by using end-to-side anastomosis between the donor＇s left atrium and the pulmonary artery. The left ventricle ejected volume through an end-to-side anastomosis of the donor＇s aorta to the recipient＇s abdominal aorta. The left ventricle and right ventricle had ejective function at the same time. Rats of heterotopic abdominal working cardiac transplant were performed by using 96 rats of preliminary experiment and 20 rats of formal experiment were involved in. RESULTS： Totally 116 SD rats entered the analysis of results. ① The successful rates of the preliminary experiment （n=96） and formal experiment （n=20） were 56% and 90% respectively. The incidence rate of main complications in the preliminary experiment was 43.8%, including anesthetic accident, bleeding or narrow of stoma, paraplegia, myocardial protection failure, shock, disorder of internal environment and early death of donor heart after operation. The incidence rate of complications in the formal experiment was 10%. ② Under oxygen intake, the partial pressures of oxygen before and after stroma were extremely and significantly different [（20.4±1.9）, （11.2±1.3） kPa, P 〈 0.01]; Without oxygen intake, the partial pressures of oxygen before and after stioma were extremely and significantly different [（9.9±1.2）, （6.7±1.2） kPa, P 〈 0.01], the partial pressure of oxygen before stroma after oxygen intake was obviously elevated as compared with that before oxygen intake （P 〈 0.01）. CONCLUSION： The prevention and treatment aiming at the reasons of the occurrence of related operative complication can acquire stable and high successful rate of abdominal working cardiac transplant models.