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门肝分流术治疗猪肝硬化门脉高压症 被引量:3

Treatment with portal vein-hepatic artery shunt for liver cirrhosis and portal hypertension in pigs
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摘要 目的观察肝侧门静脉一肝总动脉侧端分流术和侧侧分流术(统称门肝分流术)对猪肝硬化门脉高压症动物模型的治疗效果。方法对照组和实验组(即肝硬化门脉高压模型组)实验猪各15头分别行门肝分流术,观察门静脉血入肝及降压的过程。结果对照组和实验组门肝分流术前门静脉压力分别为(20.51±0.74)cmH2O(1 cm H2O=0.098kPa)和(30.82±2.53)cmH2O(P〈0.05);术后30d分别为(19.75±0.84)cmH2O和(20.84±1.36)cmH2O(P〉0.05)。对照组和实验组门静脉与肝总动脉的压力差术前分别为(7.20±0.34)cmH2O和(17.34±0.62)cmH2O(P〈0.05);术后30d分别为(6.40±0.21)cmH2O和(7.84±1.32)cmH2O(P〉0.05)。分流后术中脾静脉注射亚甲蓝肝脏染色良好。术后观察30d无肝坏死及肝性脑病发生,脾肿大恢复正常。门肝分流术对肝功能的影响较大,对其他血生化代谢指标影响较小。结论门肝分流术后虽然门静脉血入肝通道发生变更,但门脉血流动力学并未受到显著影响,反而建立了新的平衡机制来维持门脉血流动力学的稳定,达到门脉降压效果。门肝分流术后肝功能恢复所需时间较长,且需进一步治疗。 Objective To observe the therapeutic effects of end-to-side and side-to-side portal vein-hepatic artery shunts (P-H shunt) in pigs with liver cirrhosis and portal hypertension. Methods There were 15 pigs in each group (control and experimental), and the P-H shunt was made in each an- imal to observe the process of blood flow into the liver and the reduction of portal vein blood pressure. Results The portal vein pressures before the P H shunt of pigs in the control and experimental group were (20.51±0.74) cm H2O (1 cm H2O=0. 098 kPa) and (30.82±2.53) cm H2O respectively (P〈0.05). Portal vein pressures 30 days after the PH shunt were(19.75±0.84) cm H2O and (20.84± 1.36) cm H2 O respectively (P〉0.05). The portal vein pressure differences of pigs in the control and experimental group before P-H shunt were (7.20±0.34) cm H2O and (17.34±0.62) cm H2O respectively (P〈0. 05). Pressures differences 30 days after the P-H shunt were (6.40±0.21) cm H2O and (7.84±1.32) cm H2O respectively (P〈0.05). Splenic vein injection of methylene blue after the P-H shunt operation stained the liver well. No necrosis and hepatic encephalopathy occurred for 30 days after the P-H shunt, and the splenomegaly gradually returned to normal. Liver function was most affected after the operation and other biochemical markers were least affected. Conclusions The P-H shunt changed the channel of blood flow into the liver, the portal hemodynamic was not affected, and a new balanced mechanism was established to maintain the portal hemodynamic stability. However, further treatment was needed for liver function recovery.
出处 《中华肝胆外科杂志》 CAS CSCD 北大核心 2013年第9期706-710,共5页 Chinese Journal of Hepatobiliary Surgery
基金 广西壮族自治区科技厅资助项目(0719006-2-26)
关键词 肝硬化 门脉高压症 动物模型 门肝分流术 Cirrhosis Portal hypertension Animal models Portal vein-hepatic artery shunt
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