• 1.解放軍304醫(yī)院普外科（北京100037）2.美國加州大學(xué)洛杉磯醫(yī)學(xué)院肝胰移植中心實(shí)驗(yàn)室;

目的探討脾皮下易位門體分流術(shù)在大鼠原位肝移植中的應(yīng)用價(jià)值。方法Wistar 大鼠180只，供、受體各90只，供體體重略小于受體。受體鼠再隨機(jī)分為脾皮下易位門體分流術(shù)(STS)后原位肝移植(OLT)組（簡稱STS+OLT組）和原位肝移植組(簡稱OLT組)。根據(jù)受體無肝期時(shí)間，又將上述兩組分別分為A、B、C 3個(gè)亞組(無肝期分別為＜25 min、35 min和45 min左右)，每個(gè)亞組15只。在無肝期前、后不同時(shí)相收集血標(biāo)本，測定其ALT、內(nèi)毒素及pH值水平，并觀察兩組動(dòng)物術(shù)后生存率。結(jié)果在STS+OLT組，術(shù)后第7 d各亞組動(dòng)物的ALT基本恢復(fù)到正常水平，而OLT組動(dòng)物ALT水平于術(shù)后第7 d時(shí)仍明顯增高(P＜0.01)，第30 d時(shí)才接近正常水平。STS+OLT組各亞組及OLT A組動(dòng)物門靜脈血中的pH值及內(nèi)毒素水平在無肝期前、后及再灌注30 min時(shí)差異均無顯著性意義(P＞0.05)，而OLT組的B組和C組動(dòng)物門脈血中pH值及內(nèi)毒素水平在無肝期后及再灌注30 min時(shí)較無肝期明顯增加(P＜0.01)。OLT組動(dòng)物術(shù)后各時(shí)間點(diǎn)生存率與STS+OLT組相比，除A組外，前者的B組和C組動(dòng)物均明顯低于后者的B組和C組(P＜0.01)。結(jié)論脾皮下易位門體分流術(shù)可有效地防止因無肝期延長而引起的肝損害及門脈血中的pH值及內(nèi)毒素增高，并能明顯提高大鼠術(shù)后生存率。

引用本文： 李基業(yè),Jerzy KupiecWeglinski. 脾皮下易位門體分流術(shù)在大鼠原位肝移植的應(yīng)用. 中國普外基礎(chǔ)與臨床雜志, 2002, 9(4): 224-227. doi: 復(fù)制

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  2. 2. Bengmark S, Borjesson B, Olin T. Development of portosystemic shunts after subcutaneous transposition of the spleen in the rat [J]. Am J Surg, 1973; 125(2)∶757.
  3. 3. Obayashi T. Addition of perchloric acid to blood samples for colorimetric limulus test using chromogenic substrate: comparison with conventional procedures and clinical applications [J]. J Lab Clin Med, 1984; 104(3)∶321.
  4. 4. Lee S, Charters AC, Chandlers JG, et al. A technique for orthotopic liver transplantation in the rat [J]. Transplantation, 1973; 16(6)∶664.
  5. 5. Marzi I, Knee J, Menger MD, et al. Hepatic microcirculatory disturbances due to portal vein clamping in the orthotopic rat liver transplantation model [J]. Transplantation, 1991; 52(3)∶432.
  6. 6. 王志偉, 黃宇琦. 肝臟缺血再灌注損傷 [J]. 中國普外基礎(chǔ)與臨床雜志,1998; 5(4)∶253.
  7. 7. 高靜濤, 黃志強(qiáng). 腸源性內(nèi)毒素與枯否氏細(xì)胞介導(dǎo)的肝切除后肝再生調(diào)控 [J]. 中國普外基礎(chǔ)與臨床雜志, 1998; 5(4)∶249.
  8. 8. Starzl TE, Lerner RA, Dixon FJ. Effects of endotoxin on kidney grafts [J]. Engl J Med, 1968; 278(5)∶602.
  9. 9. Yokoyama I, Todo ST, Miyata T, et al. Endotoxemia and human liver transplantation [J]. Transplant Proc, 1989; 21(5)∶3833.