• 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. 中國普外基礎(chǔ)與臨床雜志, 2003, 10(2): 125-127. doi: 復(fù)制

版權(quán)信息： ?四川大學(xué)華西醫(yī)院華西期刊社《中國普外基礎(chǔ)與臨床雜志》版權(quán)所有，未經(jīng)授權(quán)不得轉(zhuǎn)載、改編

1. Paulsen AW, Whitten CW, Ramsay MA, et al. Considerations for anesthetic management during venovenous bypass in adult hepatic transplantation [Ｊ]. Anesth Analg,1989; 68(4)∶489.
2. Kuo PC,Alfrey EJ,Garcia G, et al. Orthotopic liver transplantation with selective use of venovenous bypass [Ｊ].Am J Surg, 1995; 170(6)∶671.
3. 黃潔夫，楊清水，陳規(guī)劃，等．體外靜脈轉(zhuǎn)流下的豬原位肝移植術(shù)血流動(dòng)力學(xué)及血生化的改變 [Ｊ].中山醫(yī)科大學(xué)學(xué)報(bào)，1994； 15(3)∶177.
4. de la Morena G, Acosta F, Villegas M, et al. Ventricular function during liver reperfusion in hepatic transplantation [Ｊ].Transplantation,1994; 58(3)∶306.
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.
  1. 1. Paulsen AW, Whitten CW, Ramsay MA, et al. Considerations for anesthetic management during venovenous bypass in adult hepatic transplantation [Ｊ]. Anesth Analg,1989; 68(4)∶489.
  2. 2. Kuo PC,Alfrey EJ,Garcia G, et al. Orthotopic liver transplantation with selective use of venovenous bypass [Ｊ].Am J Surg, 1995; 170(6)∶671.
  3. 3. 黃潔夫，楊清水，陳規(guī)劃，等．體外靜脈轉(zhuǎn)流下的豬原位肝移植術(shù)血流動(dòng)力學(xué)及血生化的改變 [Ｊ].中山醫(yī)科大學(xué)學(xué)報(bào)，1994； 15(3)∶177.
  4. 4. de la Morena G, Acosta F, Villegas M, et al. Ventricular function during liver reperfusion in hepatic transplantation [Ｊ].Transplantation,1994; 58(3)∶306.
  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.