内支架法原位端-端吻合大鼠移植肾静脉

A method for end-to-end anastomosis of veins of the renal allograft in rats with endoprostheses

目的建立一种省时、高效的大鼠肾移植静脉吻合方法。方法建立同种异体肾移植动物模型。根据移植肾静脉重建方式不同进行模型分组：实验组（n=32）：内支架法原位端-端吻合；对照组Ⅰ（n=25）：原位端-端吻合；对照组Ⅱ（n=22）：cuff管套扎法吻合；对照组Ⅲ（n=20）：与受体下腔静脉端侧吻合。比较各组移植肾静脉手术操作时间、手术并发症发生率。结果实验组供肾静脉切取用时同对照组Ⅲ间差异有统计学意义[（9．08±0．88）min比（12．07±0．88）min，P〈0．05]；修整用时与对照组Ⅱ间差异有统计学意义[（4．97±0．58）min比（8．14±0．64）min，P〈0．05]；对照组Ⅱ术后静脉血栓发生率最高，同实验组间差异有统计学意义（Х^2=4．77，P〈0．05）；实验组静脉吻合口狭窄的发生率最低，同对照组Ⅰ间差异有统计学意义（Х^2=3．90，P〈0．05）。结论应用内支架法行移植肾静脉端-端吻合操作时间短、并发症少，可有效解决大鼠肾移植静脉重建的问题。

Objective To establish a new venous anastomosis technique for renal transplantation in rats. Methods By using 8-10 week-old male SD rats as both donors and recipients, allograft kidney transplantation animal model was established. Ninety-nine models were divided into 4 groups according to the ways of venous anastomosis. Thirty-two allografts＇ veins were rebuilt end-to-end in situ by way of endoprostheses （experimental group）. The allografts ＇ veins were anastomosed end-to-end in situ directly as control group Ⅰ （n =25）. The allografts＇ veins of control group Ⅱ （n =22） were loop ligatured with cuff tubes before anastomosis. In the remaining 20 cases （ control group Ⅲ ）, the allografts＇ veins were anastomosed with recipients＇ inferior vena end-to-side. The operating time and complications of allografts＇ veins were observed. Results There was significant difference in time for harvesting donors＇ veins between experimental groups and control group Ⅲ [ （9.08 ± 0. 88 ） min vs （ 12.07 ± 0.88 ）min, P 〈 0.05 ]. Compared with experimental group, the time for veins clipping in control group Ⅱ was prolonged significantly [ （4.97 ± 0.58 ） min vs （ 8.14±0. 64） min, P 〈 0.05 ]. The incidence of phlebothrombosis was highest in control group Ⅱ than in experimental group （Х^2 = 4.77 ,P 〈 0.05 ）. There was significant difference in incidence of anastomotic stenosis between experimental group and control group Ⅰ （Х^2 = 3.90 ,P 〈 0. 05 ）. Conclusion To rebuild veins of transplanted kidney end-to-end in situ with endoprostheses can both save the operating time and decrease the incidence of complications.