贵州医科大学学报

2005, (03) 217-219+222

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小型猪非转流式原位肝移植无肝期控制性补液
An Experimental Research on Controlled Fluid Infusion at Anhepatic Phase in Miniature Swine Undergone Orthotopic Liver Transplantation Operation

卿德科,韩本立
QING De-ke 1, HAN Ben-li 2 (1.Hepatobiliary Surgery Center of Kunming General Hospital of PLA, Chengdu Command, Kunming 650032, China; 2.Instiute of Hepatobiliary Surgery of PLA,Southwest Hospital, The Third Military Medical University, Chongqing 400038, China)

摘要(Abstract):

目的:探讨非转流式原位肝移植时无肝期补液的适宜方法。方法:选用与人解剖生理较为接近的广西巴马小型猪30头(供、受体各15头)实施非转流式原位肝移植,分两组(控制性补液组,n=10;非控制性补液组,n=5)进行实验。结果:控制性补液组小型猪10例次肝移植术中无肝期血压(MAP)为(4.5±1.58)kPa,术后1周存活率90%(9/10);非控制性补液组无肝期血压维持于正常水平,术后并发重度肺水肿,无1例存活至1周。结论:非转流式原位肝移植时无肝期补液不宜超量过快,补液时将血压维持在低水平即可。
Objective: To investigate the effect of appropriate fluid infusion method at anhepatic phase in orthotopic liver transplantation (OLTx) operation without venovenous by pass (VVB) in swine. Methods: A simplified OLTx technique without VVB in pigs was developed. 15 OLTx were performed between pairs of Guangxi BAMA miniature swines (aged 3-6months, weighted 8-11Kg). The animals were divided into 2 groups. Group 1( n =10) received controlled fluid infusion and group 2 ( n =5) received non-controlled fluid infusion. During the anhepatic phase, hemodynamic was observed. Results: In group 1, mean arterial pressure (MAP) once decreased to (4.5±1.58) kPa during anhepatic phase, but after reperfusion, the hemodynamic status recvered promptly and became stable gradually. 90% (9/10) of these animals survived for more than 1 week. In group 2, during the anhepatic phase, MAP was normal, but serious acute pulmonary edema was developed after operation and non animal survived for 1 week. Conlusions: At anhepatic phase in OLTx operation without VVB, quick or large amount fluid infusion should be avoided. It is more appropriate and feasible to keep the arterial BP to a lower than normal level when fluid infused at anhepatic phase.

关键词(KeyWords): 肝移植;猪,雏型;非静脉转流;控制性补液
liver transplantation; swine,miniature; non-venovenous bypass; controlled fluid infusion

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作者(Author): 卿德科,韩本立
QING De-ke 1, HAN Ben-li 2 (1.Hepatobiliary Surgery Center of Kunming General Hospital of PLA, Chengdu Command, Kunming 650032, China; 2.Instiute of Hepatobiliary Surgery of PLA,Southwest Hospital, The Third Military Medical University, Chongqing 400038, China)

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