大鼠异位小肠移植模型手术技术的优化

Modified operational techniques of heterotopic small intestine transplantation model in rats

目的:建立一种稳定的大鼠异位小肠移植模型。方法:对200只Wistar大鼠进行异位小肠移植供受体手术,加强细节保护肠道,增加供肠血供,减少不必要的体循环淤血,生理压力灌注辅以全身肝素化以及低压灌肠来获得高质量供肠;熟练掌握并在20倍显微镜下连续外翻血管缝合,延迟收线以减少血管并发症;术后经阴茎背静脉安全补液。结果:实施100对小肠移植,术后3 d成功率达91%,血栓形成、低血容量性休克仍为主要死亡原因。85%的大鼠可以存活超过两周。整个手术可以在3 h内完成。结论:高质量的供肠与显微镜下血管吻合的改进以及适当补液可以提高大鼠小肠移植术后生存率,从而建立稳定的移植模型。

Objective： To establish a stable model of heterotopic small intestine transplantation in rats. Methods： Heterotopic small intes- tine transplantations were performed in 200 Wistar rats. In order to improve the survival rate, high quality of donor intestines were harvested. We first increased the blood supply for donor intestine and reduced unnecessary circulation congestion. Blood vessels were perfused with physiological pressure and systemic heparin was performed. Furthemore, the donor intestines were peffused with low pressure. The blood vessels were sutured by continuous eversion suture under 20 fold microscope and the suture was delayed to reduce vascular complications, postoperative rehydrate was peffoi^ned through dorsal penile vein. Results： The 3 day survival rate of recipients was 91%. Thrombosis and hypovolemic shocks were still the main causes of death. Eighty five percent of the rats could survive for two weeks. The whole operation last- ed in 3 hours. Conclusion： High quality of donor intestine, the improvement of vascular anastomosis technology under a microscope and postoperative rehydrate could increase the postoperative survival rate to establish a stable model of small bowel transplantation in rats.