改良腹腔内静脉转流管用于驮式肝移植的实验研究

A MODIFIED TUBE USED TO SHUNT THE ABDOMINAL BLOOD BACK TO HEART IN THE ANIMAL EXPERIMENTS OF LIVER TRANSPLANTATION (PIGGY BACK)

目的：研究自制转流管在动物背驮式肝移植中的转流效果。方法：１６只狗中８只为供体，另８只行原位背驮式肝移植，用涂有聚氨酯的乳胶管实现门静脉及下腔静脉血的转流，监测循环及肠管瘀血情况，取出转流管后观察有无凝血块。结果：手术均能完成，历时３～５ｈ。插管过程无出血，肠管无瘀血。无转流管原因引起的循环不稳。涂层内侧无凝血块。转流管接口及尖端涂层有破裂，与乳胶管之间有少量血凝块。结论：自制转流管抗凝效果良好，满足动物实验的转流要求。但涂层与乳胶管粘和不牢。

Objective:To investigate the shunt effects in vivo of the latex tube covered with a layer of polyurethanes during the animal experiments of liver transplantations (piggy back). Methods:There were 16 mongrels, of which 8 were used as donors and the other 8 as the recipients of the orthotopic liver transplantations (piggy back). Before the livers of the recipients were removed, a latex tube covered with a layer of polyurethanes was interposed between the portal vein and inferior veno cava to shunt the lower limbs and the abdominal blood to heart. The circulation and gut congestion were monitored during the operations. Whether clots were formed in the tubes was recorded after the tubes were removed. Results: All of the 8 liver transplantations (piggy back) were completed in 3 to 5 hours. There was almost no bleeding during the tube interposing. When the tubes were posed well, no gut congestion was found. Instabilities of the circulation was not associated with the tubes. No clots were formed on the inner surface of the polyurethane cover. The numbers of broken covers were inspected at the tips and the connection parts of the tubes and the clots formed between the wall of the latex tubes and covers. Conclusion: The anticoagulation effects of the shunt tubes covered with a layer of polyurethanes were good, but it was hard to make the cover adhered to the latex tube quite fixtive, so, blood could get into the space between the wall of the tube and the cover after being broken during the tube positioning and the clots formed. The making of the tube should be further improved when it is used as the abdominal blood shunting in human liver transplantation (piggy back).