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1、1.肝移植术后早期的微透析监测与临床经验(瑞典)哈徳斯菲尔徳大学医院Karolinska研究所移植乎术部BrJSurg.2002Sep;89(9):l169-75PMID:12190684背景肝移植术后的实时监测变得越来越必要；组织微透析膜技术的成熟，以及大量的动物实验检验；方法研究对彖为10名整个器官原位肝移植患者。手术后在肝内植入微透析导管。另外在腹部缝合后，立即在右胸皮卜•组织植入一根参照导管。手术示三天内连续采样，每一小时采样一次；监测项目：葡萄糖，乳酸，丙酮酸和甘汕。结果在最初的24小时
2、内，肝内葡萄糖水平高于参照组织内的含量。最初，肝内乳酸的increasedmean(s.e.m.)水平值为7.0(1.9)mmol/l,24小时后急速下降至2.7(0.3)mmol/lo肝移植后的24小时内，乳酸/丙酮酸比率卜降并逐渐稳定，从18.7(4.2)至10.0(1.1);在导管植入并稳定采样后16小时，月
3、内甘油山62.3(7.4)下降至24.3(7.5)mmol/l;总结微透析仪可连续显示移植后肝内的新陈代谢；过程简单且安全；対未來研究移植后，组织病理变化将有很大帮助；(例如动脉和门静
4、脉血栓的形成，早期急性排斥反应；)原文：BrJjurg.2002Sep;89(9):l169-75.Clinicalexperienceincontinuousgraftmonitoringwithmicrodialysisearlyafterlivertransplantation.NowakG,UngerstcdtJ,WemcnnanJ.UngerstcdtU、EriczonBG.SourceDepartmentofTransplantationSurgery,KarolinskaInstit
5、ute,HuddingeUniversityHospitalHuddinge,Sweden.grzegorz.nowak@karo.ki.seAbstractBACKGROUND:Earlydetectionofimpairedgraftfunctionaftertransplantationisessential.Microdialysispermitscontinuousmonitoringofmetabolicchangesbymimickingthepassivefunctionofaca
6、pillarybloodvesselbyperfusionofatubularsemipermeablemembraneintroducedintothetissue.Basedontheresultsofanimalexperiments,aclinicalpilotstudywasundertaken.METHODS:Tenconsecutivepatientsundergoingwhole-organorthotopiclivertransplantationwerestudied.Intr
7、ahepaticimplantationofamicrodialysiscatheterwasperformedattheendoftheoperation.Arefereneecatheterwasplacedinthesubcutaneoustissueovertherightpectoralareaimmediatelyafterabdominalclosure・Consecutiveserialsampleswerecollectedat1-hinteivalsfor3daysaftert
8、heoperation・Glucose,lactate,pyruvateandglycerolconcentrationsweremeasured・RESULTS:Duringthefirst24h,theglucoselevelwashigherintheliverthaninreferencetissue.Initially,increasedinean(s.e.m.)levelsoflactate(7.0(1.9)mmol/1)wereobservedintheliver,witharapi
9、ddecrease(to2.7(0.3)mmol/1)over24h・Adecreasein,andlaterstabilizationof,thelactate:pynivateratiointheliver,from18.7(4.2)to10.0(1.1),wasobservedwithin24haftertransplantation.Liverglycerollevelsdecreasedfi-om62.3(7.4)to24.3(7.5)micromol/1withinth
