• 瀘州醫(yī)學(xué)院附屬醫(yī)院血管外科(四川瀘州646000);

目的探討豬原位肝移植手術(shù)中體外靜脈轉(zhuǎn)流的應(yīng)用及不同轉(zhuǎn)流途徑對(duì)血流動(dòng)力學(xué)的影響。方法選擇50只健康家豬按體重接近原則配對(duì)分為供體組與受體組進(jìn)行25例原位肝移植手術(shù),受體組無(wú)肝期采用不同體外靜脈轉(zhuǎn)流途徑,其中A組(16只)經(jīng)門靜脈插管,B組(9只)經(jīng)脾靜脈插管。術(shù)中連續(xù)監(jiān)測(cè)A、B兩組動(dòng)物的血流動(dòng)力學(xué)變化。結(jié)果術(shù)后24 h,A組存活14只,B組9只全部存活。A組血流動(dòng)力學(xué)在無(wú)肝期開始及結(jié)束時(shí)均出現(xiàn)明顯波動(dòng),平均動(dòng)脈壓和中心靜脈壓下降,心率上升; B組在整個(gè)無(wú)肝期內(nèi)血流動(dòng)力學(xué)保持平穩(wěn),兩組間比較差異有顯著性意義(P<0.05)。 結(jié)論豬原位肝移植術(shù)中應(yīng)用體外靜脈轉(zhuǎn)流,有利于維持血流動(dòng)力學(xué)穩(wěn)定,而經(jīng)脾靜脈插管轉(zhuǎn)流較經(jīng)門靜脈插管轉(zhuǎn)流具有更大的優(yōu)越性。

引用本文: 何春水,何延政,田根東,鐘武. 豬原位肝移植術(shù)中體外靜脈轉(zhuǎn)流途徑的實(shí)驗(yàn)研究. 中國(guó)普外基礎(chǔ)與臨床雜志, 2003, 10(2): 125-127. doi: 復(fù)制

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  5. 5. Lo CM, Fan ST, Liu CL, et al. Adulttoadult living donor liver transplantation using extended right lobe grafts [J]. Ann Surg,1997; 226(3)∶261.