猪全胰十二指肠移植术的麻醉技术及围术期管理探讨

目的-以肠内引流(enteric drainage，ED)和门静脉回流(Portal venous drainage，PVD)术式，建立猪全胰十二指肠移植模型，探讨该术式的麻醉及围术期管理方法，为临床胰腺移植积累经验。方法-供、受体猪各20只，基础麻醉后建立心电监护，硫喷妥钠静脉诱导，暴露声门后，静注司可林气管插管，机控呼吸，术中以芬太尼、咪唑安定、哌库溴铵、硫喷妥钠维持麻醉。直视下右颈总动脉、右颈外静脉穿刺置管，连续监测并记录平均动脉压、心率、经皮脉搏氧饱和度及中心静脉压，测定血糖及胰岛素、胰高血糖素水平。结果-成功建立胰腺移植模型并改进了诱导插管方法，气管插管一次成功率95％。采用静脉复合麻醉，苏醒迅速、安全。无胰期积极扩容可保证新胰灌注后呼吸循环稳定。

Anesthesia Technic and Perioperative Management in Pigs with Pancreatic-duodenal Transplantation

Objective To establish the model of pancreatic-duodenal transplantation with portal-enteric drainage in pigs and to investigate anesthesia technic and perioperative management of the procedure. Methods Forty pigs were matched according to the weight and assigned randomly to the donor and recipient groups. After basic anesthesia, the animals were induced with thiopental sodium and intubation was facilitated with succinylcholine. Then mechanical ventilation was applied, and the anesthesia was maintained with the combination of midazolam, fentanyl, pipecuronium and thiopental intravenously. The right internal carotid artery was cannulated in order to monitor the mean artery pressure,the heart rate,SpO 2 and the central venous pressure simultaneously.The blood samples from right jugular vein were collected for analyzing the concentration of blood sugar, insulin and glucagon. Results The model was set up successfully and the intubation was improved with the successful rate of 95%. Conclusion The anesthesia was performed easily and securely. Proper volume expansion therapy during the apancreatic stage could maintain hemodynamic and respiratory stabilization after infusion of the graf.