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目的探讨稳定的小鼠异位小肠移植模型制作方法,为小肠移植排斥反应的研究提供良好的实验工具。方法选用C57BL/6小鼠作供体和BALB/c小鼠作受体进行同种异基因型异位节段性小肠移植。采用小肠供体的门静脉与受体下腔静脉端侧吻合,供体带主动脉片的肠系膜上动脉与受体腹主动脉端侧吻合,供体近端肠管结扎,远端与受体空肠端侧吻合的方式建立异位小肠移植。术后禁食3天,不禁饮,每天分两次经皮下分别给予5%葡萄糖生理盐水2 mL,术后不使用抗生素和免疫抑制剂。小鼠存活超过5 d视为手术成功。结果共行小肠节段性移植30例,术后5 d存活率达70%(21/30)。供体手术时间(41±5.5)min,热缺血时间约0.5 min,供体肠段肠系膜上动脉组织片修整时间约为3 min,供体冷保存时间为(30±7.5)min,受体手术时间(90±7.5)min,其中腹主动脉及下腔静脉阻断时间为(40±3.0)min,静脉吻合时间(10±2.0)min,动脉吻合时间(15±2.5)min,成活小鼠受体手术平均出血量约0.2 mL。手术失败的9例小鼠的死亡原因为动脉吻合口部位狭窄及吻合口处血栓形成(6例),吻合口出血导致出血性休克(2例)和术后腹腔内感染(1例)。结论良好的供体肠段的获取、高质量的血管吻合和肠道吻合及供、受体补液是提高小鼠小肠移植手术成功率的关键。
Objective To investigate a stable mouse model of ectopic small bowel transplantation and to provide a good experimental tool for the study of small bowel transplantation rejection. Methods C57BL / 6 mice were used as donors and BALB / c mice as recipients for allogeneic segmental small bowel transplantation. The portal vein of the small intestine donor was anastomosed to the inferior vena cava of the recipient. The superior mesenteric artery of the donor aorta was anastomosed with the abdominal aorta of the recipient. The donor’s proximal intestine was ligated. Side of the way to establish ectopic small bowel transplantation. Postoperative fasting 3 days, can not help but drink, were given twice daily subcutaneous 5% glucose saline 2 mL, postoperative do not use antibiotics and immunosuppressive agents. Mice survived more than 5 days as a successful operation. Results A total of 30 cases of small intestine segmental graft, the survival rate of 5 d after surgery was 70% (21/30). Donor donor (41 ± 5.5) min, warm ischemia time was about 0.5 min, donor mesenteric artery segment tissue dressing time was about 3 min, donor cold preservation time was (30 ± 7.5) min, receptor The time of operation (90 ± 7.5) min, the time of occlusion of abdominal aorta and inferior vena cava (40 ± 3.0) min, vein anastomosis time (10 ± 2.0) min and artery anastomosis time (15 ± 2.5) min, The average volume of murine receptor surgery was about 0.2 mL. The causes of death of the nine mice failed in the surgery were stenosis of the anastomotic anastomosis and thrombosis at the anastomotic site (6 cases), hemorrhagic shock (2 cases) caused by anastomotic bleeding and intraperitoneal infection (1 case). Conclusion Good donor intestine segment access, high quality vascular anastomosis and intestinal anastomosis and donor and recipient fluid replacement are the keys to improve the success rate of small bowel transplantation in mice.