论文部分内容阅读
目的建立符合正常生理特点的胰岛素门静脉回流胰液内引流式胰肾联合移植(SPK)动物模型。方法选用20头近交系甘南小型猪作为SPK的供受体。供胰肾原位灌注后整块切取。修整时行供体左肾静脉与脾静脉端端吻合。受体血管吻合采用供体门静脉与受体脾静脉端侧吻合,供体腹主动脉的远端与受体的腹主动脉斜侧吻合;供体十二指肠与受体空肠侧侧吻合,使胰液经节段十二指肠从肠道引流;供肾输尿管皮肤造瘘并置管体外引流用于监测尿量。全组均未作抗排斥处理。结果10头受体猪中除1头因严重的腹胀于术后1 d死亡外,其余9头平均存活(4.5±1.5)d,术后移植胰、肾均即可发挥功能。结论在小型猪建立门静脉回流胰液内引流式SPK模型是可行的,且该术式更符合生理特点,可望用于临床。
OBJECTIVE: To establish an animal model of pancreaticoduodenectasis (SPK) combined with insulin in portal vein refluxing pancreatic juice in accordance with normal physiological characteristics. Methods 20 inbred line Gannan miniature pigs were selected as SPK donor. Pancreatic kidney for in situ perfusion after the whole cut. Trim row donor left renal vein and splenic vein anastomosis. Recipient vascular anastomosis using the donor portal vein splenic vein with the recipient side of the anastomosis, donor distal abdominal aorta with the abdominal aorta of the recipient anastomosis; donor duodenum and recipient jejunum lateral anastomosis, So that the pancreatic juice through the segment duodenum drainage from the intestine; for renal ureteric skin fistula and catheter drainage for monitoring the volume of urine. The whole group did not make anti-rejection treatment. Results All but one of the 10 recipient pigs died of severe abdominal distension on the first postoperative day. The other nine survived (4.5 ± 1.5) d on average. After transplantation, the function of the pancreas and kidney were achieved. Conclusion It is feasible to establish drainage SPK model of portal vein reflux pancreatic fluid in miniature pigs, and this technique is more suitable for physiological characteristics and is expected to be used clinically.