目的：改进大鼠原位左肺移植技术，建立快速、安全、可重复性强的大鼠肺移植动物模型的方法。方法SPF 级健康雄性 SD 大鼠90只，体质量300～350 g。其中60只作为供、受体，受体略大于供体，供、受体间体质量差不超过20 g，运用三袖套法吻合左肺动、静脉及支气管以建立大鼠左肺移植模型，移植成功后的受体在48 h 后取肺静脉血进行血气分析（PO2、PCO2）；30只为对照组，肺静脉取血进行血气分析。观察记录大鼠肺移植供肺获取、套管及受体移植时间；移植肺血液循环及膨胀情况；移植肺与对照组血气分析结果比较。结果完成大鼠肺移植手术30例，成功27例，失败3例（肺静脉撕裂1例，脱机失败1例，肺动脉扭转1例）。大鼠供肺获取时间为（13．5±2．0）min，供肺套管时间为（15．5±2．5）min；游离大鼠受体左侧肺门部动、静脉及支气管并套线、结扎时间为（19．2±2．0）min；吻合时间为（18．5±4．0）min。在先开放肺动脉血流，接着开放肺静脉血流后，移植的左侧肺叶颜色均匀一致的红润，左肺血流得到充分的灌注，静脉充盈良好，回流畅通；恢复机械通气后，27例移植肺膨胀良好。左肺移植成功48 h 后，肺移植大鼠右侧肺门夹闭5 min 后 PO2为（7．88±0．84）kPa，PCO2为（6．67±1．09）kPa；对照组大鼠夹闭右侧肺门5 min 后肺静脉 PO2为（8．55±0．97）kPa，PCO2为（6．20±0．88）kPa。2组 PO2比较差异有统计学意义（P ＜0．05），PCO2比较差异无统计学意义（P ＞0．05）。结论改进后的肺移植技术可为大鼠肺移植的相关研究提供稳定、可靠及可重复的动物模型。%ABSTRACT:Objective To improve the technique of orthotopic left lung transplantation in rats, and to establish a fast,safe and repeatable method for rat lung transplantation.Methods Ninety healthy male SPF SD rats weighing 300-350 g were used in this study.Among them,60 were used as donors and acceptors(acceptors were slightly larger than donors,and weight difference did not exceed 20 g),and 30 as controls.Three-cuff method was used for the anastomosis of left pulmona-ry arteries,veins and bronchi to establish the rat model of left lung transplantation.Pulmonary venous blood was collected 48 hours after transplantation for blood gas analysis in acceptors,as well as in controls.Donor lung harvesting time,cuffing time and transplant time were recorded, and blood circulation and inflation situation of the transplanted lung were observed.Results Lung transplantationwere completed in 30 rats.Among them,the transplantation was successful in 27,and failed in 3(pulmonary vein tear in 1,weaning failure in 1,and pulmonary artery torsion in 1).The donor lung harvesting time,cuffing time and anastomosis time were(13.5±2.0),(15.5± 2.5)and(18.5±4.0)minutes,respectively.The time for dissociating arteries,veins and bronchi in the left lung hilum,suturing and ligating was(19.2±2.0)minutes.After opening pulmonary arteries and veins successively,the lobe of transplanted lung showed a uniform ruddy color with sufficient blood perfusion,good venous filling and unobstructed venous return.After restoring mechanical ventilation,all the rats undergoing successful transplantation had good lung inflation. At 48 hours after left lung transplantation,PO2 and PCO2 were,respectively,(8.55±0.97)and (6.20±0.88)kPa in controls,and(7.88±0.84)and(6.67±1.09)kPa in acceptors after right hi-lus was clipped for 5 minutes.The difference in PO2 ,but not in PCO2 ,was significant between the two groups(P <0.05).Conclusion The improved lung transplantation technique can provide a stable,reliable and repeatable animal model for lung transplantation-related research.
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