猪自体肝移植静脉转流过程中血流动力学研究

Study on hemodynamics in venous bypass for autologous liver transplantation of pig

目的：观察自体肝移植转流过程中血流动力学改变。方法长白猪20只，猪龄为30 d，雌雄不限，体质量约20～25 kg。进行自体肝移植静脉转流。在体外经下腔静脉和脾静脉插管，通过“Y”型管连接左侧颈外静脉插管经磁力泵进行转流，建立自体肝移植模型。观察转流前和转流30 min、60 min、90 min、120 min血流动力学变化并记录分析。并取小肠和肾脏组织做病理检测转流效果。转流过程中根据血气分析调整内环境的稳定。结果各个实验组转流120 min，体温维持在36.5℃左右，转流总流量维持在（0.52±0.11） L/min（P〉0.05）。各时间点中心静脉压、心率、收缩压、舒张压均能保持稳定。转流结束前输液量为（965±16） mL（P〉0.05）。小肠和肾脏无淤血。管道中未发现血栓。结论在自体肝移植的转流过程中没有大量输液及输血的情况下能够完成120 min转流。

Objective To observe the hemodynamics changes in the process of venous bypass for autologous liver transplantation. Methods Twenty Landrace pigs（male or female）, aged 30-day and weighted about 20-25 kg, were used as experimental animals for autologous liver transplantation. Inferior vena cava and spleen vein were connected by “Y”type tube in vitro, and then connected to the left external carotid vein transferred via magnetic pump, by which auto liver transplantation model was established. The hemodynamic changes at the pre-bypass, bypass 30-minute, 60-minute, 90-minute and 120-minute were observed and analyzed, respectively. The effect of venous bypass was tested by small intestine and kidney pathology slice. During the process, the internal environment was regulated by blood gas analysis. Results The 120-minute bypass was performed in every group and pigs’ temperatures were maintained at about 36.5℃, the bypass flow was maintained at the level of （0.52 ± 0.11） L/min. The central venous pressure（CVP）, heart rate（HR）, systolic blood pressure（SBP） and diastolic blood pressure（DBP） in every time point maintained stable, and the infusion quantity at the end of bypass maintained at （965 ± 16） mL （P〉0.05）. No congestions were found in intestine and kidney, and there was no thrombus observed in blood vessels. Conclusion It is demonstrated that the 120-minute bypass could be successfully performed in pig autolougous liver transplantation model without large amount of fluids and blood transfusion.