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目的:建立猪自体肺移植实验动物模型,为临床开展自体肺移植术提供实验基础。方法:健康杂种猪18只,分别行左侧第四肋间开胸,游离肺门后行左全肺切除,予修剪左下肺后,将离体的左下肺重新植入胸腔,即把下肺静脉重植于上肺静脉残端,并依次完成支气管和肺动脉吻合。依据术中左下肺叶是否行灌注和灌注液的不同,分为3组,每组6只,分别为:A组(未灌注组)、B组(常温肝素灌注组)及C组(低温Euro-Collins液灌注组)。分别于移植前、移植后0.5、1.0、2.0、4.0h检测移植肺的肺静脉血氧分压(PaO2)、湿干重比(W/Dratio)、氧自由基髓过氧化物酶(MPO)活性;观察移植肺组织的光镜及电镜结构变化。结果:手术无一例失败,均存活。移植前,移植后0.5、1.0、2.0h3组移植肺的肺静脉血PaO2、肺组织的MPO和W/D无显著性差异(P>0.05);与对A组相比,B组和C组移植后4h的PaO2、MPO和W/D均有显著性差异(P<0.05)。与A组相比,B组及C组病理损伤较轻,且两组损伤程度相似。结论:本模型稳定、可靠、重复性好,是研究自体肺移植较为理想的动物模型;常温肝素灌注后的供肺叶能满足自体肺移植的要求。
OBJECTIVE: To establish an experimental animal model of porcine autologous lung transplantation to provide experimental basis for clinical autologous lung transplantation. Methods: Eighteen healthy pigs were divided into four intercostal thoracotomy on the left side and left pneumonectomy on the left hilum. After the left lower quadrant was pruned, the isolated left lower lung was replanted into the thoracic cavity, Replanted in the stump of the pulmonary veins, and in turn completed bronchial and pulmonary anastomosis. According to whether the left lower lobe in the operation of perfusion and perfusion fluid is divided into three groups of six, respectively: A group (non-perfusion group), B group (normal temperature heparin perfusion group) and C group (low temperature Euro- Collins fluid perfusion group). The pulmonary venous oxygen pressure (PaO2), wet / dry weight ratio (W / Dratio), oxygen free radical myeloperoxidase (MPO) activity were measured at 0.5, 1.0, 2.0 and 4.0 h after transplantation. The changes of light and electron microscopy in lung tissues were observed. Results: None of the procedures failed and survived. Before transplantation, there was no significant difference in the pulmonary venous blood PaO2, pulmonary MPO and W / D in 0.5, 1.0 and 2.0 h3 groups (P> 0.05). Compared with group A, B and C groups After 4h PaO2, MPO and W / D were significantly different (P <0.05). Compared with group A, group B and C had less pathological damage, and the degree of injury was similar in both groups. Conclusion: This model is stable, reliable and reproducible. It is an ideal animal model for the study of autologous lung transplantation. The supply of lung lobe after autologous lung transplantation can meet the requirements of autologous lung transplantation.