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目的总结中国小型猪非转流条件下原位肝移植的手术特点,探索建立成熟、稳定的移植模型。方法通过18例次非转流条件下中国小型版纳猪原位肝脏移植术,结合手术特点进行技术改进,观察围手术期血液动力学及重要代谢指标的变化,观察手术技术改进及术后处理对存活率的影响。结果所有手术无术中死亡,术后7d存活率88.9%。平均手术时间(179.6±14.3)min,平均无肝期(27.3±3.4)min。无肝期血液动力学及生化代谢波动明显。术后当天麻醉清醒,术后3￣5h左右开始自行排出小便,术后第3天正常进食。结论无肝期手术时间的缩短及血液动力学的相对稳定是非转流条件下猪原位肝移植成功的关键。
Objective To summarize the surgical characteristics of orthotopic liver transplantation under the non-diverting condition of Chinese miniature pigs, and to establish a mature and stable transplantation model. Methods 18 cases of non-diverting conditions in China Mini Banna pig orthotopic liver transplantation, combined with surgical techniques to improve the technology to observe perioperative hemodynamics and important metabolic changes, observation of surgical techniques and postoperative treatment of Effect of survival rate. Results All operations without surgery died, the survival rate after 7 days 88.9%. The average operation time (179.6 ± 14.3) min, mean anhepatic period (27.3 ± 3.4) min. Hemodynamics and biochemical metabolism in anhepatic phase have obvious fluctuation. Anesthesia on the day after surgery awake, about 3 ~ 5h after surgery began to discharge urine, the first three days after normal eating. Conclusions The shortening of the operative time and the relative stability of hemodynamics during anhepatic phase are the keys to successful orthotopic liver transplantation in non-bypass conditions.