【摘要】 目的:探讨减轻无心跳供体(non-heart-beating donor,NHBD)肺热缺血损伤的方法,以更好地保存尸体肺的结构和功能。方法:将64只SD大鼠随机分成4组,每组8对,用"两套管一支架法"完成左肺原位移植。HBD组为有心跳供体组,NHBD-N组为无心跳供体且未采取保护措施组,NHBD-V和NHBD-I组分别采取持续机械通气和胸腔冰盐水降温的保护措施。完成肺移植后,比较4组的肺顺应性、肺功能、肺水含量、能量代谢物含量等各项指标。结果:NHBD肺存在较长的热缺血时间,与HBD肺相比肺损伤更为严重。但是NHBD-V和NHBD-I组与NHBD-N组比较,移植术后肺水含量更低(4.21±0.85,4.14±1.33,5.28±1.24,均P<0.01)、肺损伤指数(11.28±3.26,10.41±2.85,14.35±3.21,均P<0.01)和白细胞浸润程度(316.30±56.24,295.50±70.26,425.60±86.47,均P<0.01)更轻,而肺顺应性和肺能量代谢物保存更好。结论:大鼠NHBD肺在热缺血时给予持续机械通气或胸腔低温浸泡均可取得良好的肺保护效果。更多还原

【Abstract】 Objective To investigate the methods to alleviate lung injury of non-heart-beatin donor to attain better structure and function.Methods Sixty-four Sprague-Dawley rats were randomly divided into 4 groups: a heart-beating donor group(HBD group),a non-heart-beating donor group without protective measures(NHBD-N group),a non-heart-beating donor group with continuous mechanical ventilation or with topical cooling on cadaver lung(NHBD-V group and NHBD-I group).After the transplantation,lung compliance,pulmonary function,wet/dry ratio of lung and content of energy metabolism were compared among the 4 groups.Results Due to the longer warm ischemic period,NHBD lungs suffered more injuries than HBD lungs.However,compared with NHBD-N group,the wet/dry ratio of the lung in NHBD-V group and NHBD-I group was lower(5.28±1.24,4.21±0.85,4.14±1.33,P<0.01),the lung injury index(14.35±3.21,11.28±3.26,10.41±2.85,P<0.01)and the count of white blood cells(425.60±86.47,316.30±56.24,295.50±70.26,P<0.01)were milder,while the lung compliance and preservation of energetic metabolte were better in the NHBD-V group and the NHBD-I group.Conclusion Continuous mechanical ventilation or topical cooling may protect the NHBD lung during the warm ischemic period.更多还原