大鼠原位小肠移植手术技巧及常见并发症

Operative techniques and common complications of modified orthotopic intestinal transplantation in rats

目的探讨大鼠原位小肠移植术的手术技巧及常见并发症的处理和预防。方法用改进的三袖套法对120只大鼠进行原位小肠移植术，总结手术技巧，分析常见并发症的发生原因及相应的处理和预防措施。结果术后有99只大鼠（82．5％）生存超过1周。死亡21只。受体术中出血平均少于1ml。导致大鼠死亡的原因为术中吻合121大出血（5只，4．2％）、门静脉血栓形成（2只，1．7％）、门静脉大量空气栓塞（1只，0．8％）、动脉血栓形成（4只，3．3％）、吸人性肺炎（2只，1．7％）、感染（4只，3．3％）、麻醉意外（2只，1．7％）和肠扭转（1只，0．8％）。结论娴熟细致的外科操作、熟悉各种并发症的原因并采取相应的措施可有效提高手术成功率。

Objective To investigate operative techniques, treatment and precaution of common complications of orthotopic intestinal transplantation in the rats. Methods Orthotopie intestinal transplantation was performed in 120 rats by modified three cuffs method. The causes, treatment and precaution of common complications were analyzed retrospectively. Results The 7-day survival rate of recipients was 82.5% and the 30-day survival rate was 68.3%. The average volume of bleeding in the recipient operation was less than 1 ml. The result obtained from the above 99 recipients was satisfactory. The main reasons of final failure and death were as follows： anastomotic bleeding （5 rats）, portal vein thrombus （2 rats）, arterial thrombus （4 rats）, air embolism （1 rat）, infection of abdominal cavity（4 rats）, aspiration pneumonitis （2 rats）, anesthetic accident（2 rats） and kinking of graft intestine （1 rats）. Conclusions The sophisticated surgical technique and the delicate surgical manipulation are the prerequisite of preventing operational complication. Improving operative techniques and being familiar with the common complications can reduce the occurrence of complications and increase operative successful rate.