本文選題：陰莖 + 解剖　； 參考：《中華男科學(xué)雜志》2017年08期

【摘要】：目的:探討成年比格犬作為同種異體陰莖移植動(dòng)物模型可行性,進(jìn)一步探討穩(wěn)定的陰莖移植動(dòng)物模型建立條件。方法:按照實(shí)驗(yàn)動(dòng)物模型建立原則,進(jìn)行移植陰莖相似性、重復(fù)性、可行性、適用性和可控性研究。20只成年比格犬陰莖與10例成人陰莖解剖學(xué)要點(diǎn)比較,分析主要存在的共同特點(diǎn)和相似性;10對(duì)成年比格犬陰莖在顯微外科技術(shù)輔助下進(jìn)行交叉移植,并采用FK506+MMF+MP免疫抑制方案,觀察移植陰莖存活情況;10只顯微外科技術(shù)輔助比格犬陰莖離斷再植術(shù)相關(guān)指標(biāo)進(jìn)行可操作性比較。結(jié)果:20只成年比格犬陰莖解剖學(xué)觀察與10例成人陰莖解剖學(xué)觀察具有高度相似性,相互比較統(tǒng)計(jì)學(xué)上無(wú)明顯差異。10對(duì)成年比格犬陰莖交叉移植手術(shù)均獲得成功,術(shù)后8只出現(xiàn)移植陰莖壞死,12只移植陰莖成功存活,恢復(fù)排尿功能;顯微外科技術(shù)輔助下一次性靜脈吻合成功率達(dá)95.0%(38/40),一次性動(dòng)脈吻合成功率達(dá)87.5%(35/40),血管吻合時(shí)間(71.0±9.0)min,手術(shù)時(shí)間(133.0±10.3)min,失血量(135.8±41.4)ml。比較10只顯微外科技術(shù)輔助下比格犬陰莖離斷再植手術(shù),一次性靜脈吻合成功率達(dá)100%(20/20),一次性動(dòng)脈吻合成功率達(dá)90.0%(18/20),血管吻合時(shí)間(65.0±7.9)min,手術(shù)時(shí)間(117.4±10.0)min,失血量(85.0±10.8)ml。12例臨床顯微外科技術(shù)輔助下成人陰莖離斷再植手術(shù),一次性靜脈吻合成功率達(dá)100%(24/24),一次性動(dòng)脈吻合成功率達(dá)95.8%(23/24),血管吻合時(shí)間(79.0±17.6)min,手術(shù)時(shí)間(125.0±20.6)min,失血量(140.0±44.3)ml。3組資料經(jīng)統(tǒng)計(jì)學(xué)分析顯示各項(xiàng)指標(biāo)無(wú)顯著性差異。結(jié)論:比格犬陰莖海綿體結(jié)構(gòu)與人陰莖海綿體結(jié)構(gòu)具有高度相似性,在陰莖海綿體橫斷面解剖中其主要解剖結(jié)構(gòu)均相同;顯微外科技術(shù)輔助下行比格犬陰莖再植和同種異體移植手術(shù)均獲得了成功,其手術(shù)操作過(guò)程中各項(xiàng)指標(biāo)與臨床中人陰莖再植手術(shù)相比較,具有相近的可操作性、重復(fù)性和較強(qiáng)的可行性。因此,采用成年比格犬作為實(shí)驗(yàn)動(dòng)物建立陰莖移植手術(shù)模型切實(shí)可行。
[Abstract]:Objective: to investigate the feasibility of adult Beagle as an animal model of penis allograft and to explore the conditions for establishing a stable penis transplantation model. Methods: according to the principle of establishing experimental animal model, the similarity, repeatability, feasibility, applicability and controllability of penis transplantation were studied. 20 adult Beagle penises were compared with 10 adult penis anatomical points. To analyze the common characteristics and similarities of the common features and similarities, we performed cross transplantation of adult Beagle penis with the aid of microsurgical technique, and adopted FK506 MMF MP immunosuppressive protocol. To observe the survival of the transplanted penis and to compare the relevant indexes of 10 microsurgical assisted Biger dogs with replantation of the penis. Results the penile anatomy of 20 adult Beagle dogs was highly similar to that of 10 adults. After operation, 8 cases had necrotic penis grafts and 12 of them survived successfully, and recovered urination function. The success rate of one-off venous anastomosis was 95.0 / 40, and the successful rate of one-off arterial anastomosis was 87.5a / 35 / 40m, the time of vascular anastomosis was 71.0 鹵9.0min, the operative time was 133.0 鹵10.3min, and the blood loss was 135.8 鹵41.4ml / ml. To compare the microsurgical technique in 10 Beagle dogs with penile amputation and replantation. The success rate of one-off venous anastomosis was 100% 20 / 20, and the success rate of one-off arterial anastomosis was 90.00.18 / 20, the time of anastomosis was 65.0 鹵7.9 min, the operative time was 117.4 鹵10.0 min, and the amount of blood loss was 85.0 鹵10.8)ml.12 assisted by clinical microsurgical technique. The success rate of one-off venous anastomosis was 100% 24 / 24, the success rate of one-off arterial anastomosis was 95.880 / 24, the time of vascular anastomosis was 79.0 鹵17.6 min, the operative time was 125.0 鹵20.6 min, and the blood loss was 140.0 鹵44.3)ml.3. There was no significant difference between the two groups by statistical analysis. Conclusion: the structure of the corpus cavernosum of the Beagle dog is highly similar to that of the human corpus cavernosum, and its main anatomical structure is the same in the cross-sectional anatomy of the corpus cavernosum of the penis. The microsurgical technique was used to assist in the operation of penis replantation and allograft transplantation in Beagle dogs. The indexes of the operation were similar to those of the clinical human penis replantation and had similar maneuverability. Repeatability and strong feasibility. Therefore, it is feasible to establish the model of penis transplantation by using adult Beagle as experimental animal.
【作者單位】： 廣州軍區(qū)廣州總醫(yī)院泌尿外科;
【基金】：國(guó)家自然科學(xué)基金(30872577)~~
【分類(lèi)號(hào)】：R-332;R699.8

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