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| 題 名 | Experience with Intestinal Transplantation in Dogs=狗體小腸移植的初步經驗 |
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| 作 者 | 賴鴻緒; 李伯皇; 杜元超; 陳維昭; 陳志榮; 朱樹勳; | 書刊名 | 中華民國外科醫學會雜誌 |
| 卷 期 | 28:4 民84.07-08 |
| 頁 次 | 頁262-267 |
| 分類號 | 416.175 |
| 關鍵詞 | 狗體; 小腸移植; Intestinal transplantation; Rejection; |
| 語 文 | 英文(English) |
| 中文摘要 | 臟器移植是近年來醫學界發展重點之一,但相較腎臟、心臟、肝臟等器官移植之突飛猛進,小腸移植之成功率一直無法突破,究其原因,最主要為嚴重的排斥現象及因而引起的腸道功能不彰。本研究為了解小腸移植技術之可行性及排斥現象,採用十對雄性雜種狗作實驗,以平均15.5公斤重的狗切下一段約一公尺長的小腸,移植給平均12.3公斤重的狗為接受者。切下之移植腸段以4℃Lactate Ringer溶液灌注後,以威斯康辛大學溶液保存,在移植時則採端對端吻合方式來縫合兩邊之上腸系動靜脈。接受者狗之小腸亦切掉約一公尺,先將剩餘腸道作端對端吻合,而移植入之小腸則在腹壁上作空腸及迴腸造瘻口。所有質驗狗在術後第七天均犧牲採樣,並於術前及術後第1、3、5、7天採血液及造瘻口之空腸迴腸組織作檢查,檢查項目包括血液淋巴球數目、血清肝腎功能指標、及空腸迴腸之組織切片檢視等。實驗結果,十隻接受小腸移植之狗均能活到第七天,其病理發現包括:(1)術後第五天開始均見血液中白血球及淋巴球明顯上升;(2)術後第五天開始,移植段空腸及迴腸之黏膜及黏膜下層均有明顯的淋巴球浸潤現象;(3)至術後第七天移植段空腸迴腸黏膜之表皮細胞均已壞死並可見到顯微積膿的現象。本實驗結果顯示,小腸移植在操作技術上並不困難,但強烈之排斥作用仍待更多的研究來克服。 |
| 英文摘要 | Application of intestinal transplantation to the clinical setting is very new. The main purpose of this project was to study graft rejection after intestinal transplantation. Ten pairs of male mongrel dogs, each weighing around 15 kg, were used as subjects. Intestinal transplantation of about one meter in length was done with end-to-end superior mesenteric artery and superior mesenteric vein anastomosis. University Wisconsin solution was used for graft preservation. Graft jejunostomy and ileostomy were also performed. Blood and tissue samples from jejunostoma and ileostoma were taken before and on days one, three, five, seven after operation. All dogs were sacrificed on the seventh postoperative day. Measurements were done of (1) blood lymphocyte count; (2) serum indicators of liver, renal function and nutritional indicators; (3) histopathologic changes of graft jejunum and ileum. Intestinal transplantation was performed successfully in ten pairs of dogs. The findings of rejection were that: (1) white blood cell and lymphocyte counts increased significantly from the fifth postoperative day; (2) lymphocyte infiltration into graft jejunum and ileum mucosa and submucosa area could be identified markedly from the fifth postoperative day; and (3) epithelium necrosis with micro abscess was noted on the seventh day. This suggests that the technique of intestinal transplantation is feasible, but that severe rejectional phenomenon is still a problem to be resolved. |
本系統中英文摘要資訊取自各篇刊載內容。