本文選題：子宮移植　切入點：器官保存　出處：《山東大學學報(醫(yī)學版)》2017年01期

【摘要】：目的探討人離體子宮組氨酸-色氨酸-酮戊二酸鹽(HTK)液冷灌注及冷缺血保存的安全區(qū)間。方法取因?qū)m頸癌行廣泛子宮切除術的患者子宮7例,3例于低溫條件下用HTK液經(jīng)子宮動脈灌注,測定一定灌注壓力所對應的灌注高度,建立灌注高度與灌注壓之間關系的數(shù)學模型;4例在適當灌注高度下短時灌注后取子宮內(nèi)膜及肌組織于HTK保存液和生理鹽水中保存,兩組又根據(jù)保存時間(0、3、6、24 h)的不同分為0 h組、HTK 3 h組、HTK 6 h組、HTK 24 h組、生理鹽水3 h組、生理鹽水6 h組和生理鹽水24 h組,測定不同保存時限的子宮組織細胞形態(tài)及平滑肌收縮能力,分析離體子宮灌注后冷缺血最佳保存時限。結果灌注壓90~140 mm Hg對應的灌注高度為62~122 cm;與0 h組比較,HTK3 h組和HTK6 h組的子宮標本在光鏡及電鏡下形態(tài)學結構均未見明顯改變,但HTK 24 h組及所有的生理鹽水保存組的樣本均出現(xiàn)不同程度的細胞水腫、細胞間失去聯(lián)系、線粒體腫脹及染色質(zhì)粗染等不可逆的退化性改變;HTK 3 h、HTK 6 h和HTK 24 h組的3組標本的肌收縮力差異均無統(tǒng)計學意義(P=0.772);而與相同時段HTK組標本相比,生理鹽水3 h、6 h和24 h組標本的肌收縮最大波幅均明顯降低(P0.05)。結論人類離體子宮組織低溫HTK液安全灌注高度是62~122 cm,短時灌注后4℃HTK液保存狀態(tài)下可耐受冷缺血至少6 h。
[Abstract]:Objective to investigate the safe interval of cold perfusion and cold ischemia preservation of human uterine histidine-tryptophan-ketoglutarate (HTK) solution.Methods 7 patients with cervical cancer underwent extensive hysterectomy and 3 patients were perfused with HTK solution through uterine artery under hypothermia. The perfusion height corresponding to a certain perfusion pressure was measured.A mathematical model of the relationship between perfusion height and perfusion pressure was established in 4 cases. The endometrium and muscle tissue were taken for preservation in HTK preservation solution and normal saline after infusing for a short time at the appropriate perfusion height.According to the different preservation time, the two groups were divided into 0 h group and HTK 3 h group, HTK 6 h group, normal saline 3 h group, normal saline 6 h group and normal saline 24 h group.The morphology of uterine tissue cells and the contractility of smooth muscle were measured with different preservation time, and the optimal preservation time of cold ischemia after uterine perfusion in vitro was analyzed.Results the perfusion height corresponding to the perfusion pressure of 90g 140mm Hg was 62 ~ 122cm. Compared with the 0 h group, there was no obvious change in the morphological structure of the uterine specimens in the HTK3 h and HTK6 h groups under light and electron microscope.However, the samples of HTK 24 h group and all the saline preservation groups showed various degrees of cell edema, and the cells lost contact with each other.There was no significant difference in muscle contractility between HTK3h- HTK6 h and HTK 24h groups, but there was no significant difference in muscle contractility between HTK3h- HTK6 and HTK 24h groups, but there was no significant difference in muscle contractility between HTK group and HTK group at the same time.The maximal amplitude of muscle contraction was significantly decreased in 6 h and 24 h groups of normal saline group (P 0. 05%, P 0. 05%, P 0. 05%, P 0. 05%).Conclusion the safe perfusion height of cryogenic HTK solution in human isolated uterus is 62 ~ 122cm, and the cryogenic ischemia can be tolerated at least 6 h after short-term perfusion with HTK solution at 4 鈩，

本文編號：1696691