脾次全切除术治疗门脉高压症的实验研究  

Experimental study of subtotal splenectomy for treating portal hypertension

作　　者：刘程伟[1] 胡新华[2] 张雪松[1] 王树卿[1] 罗维[1] 张强[2] 

机构地区：[1]佳木斯大学附属第一医院普通外科,黑龙江佳木斯154002 [2]中国医科大学附属第一医院外科

出　　处：《中国医科大学学报》2007年第5期539-541,共3页Journal of China Medical University

基　　金：黑龙江省教育厅科研基金资助项目(11521275);黑龙江省青年学术骨干支持计划基金资助项目(1152G041)

摘　　要：目的:检测门脉高压症脾次全切除术后细胞免疫、体液免疫和组织学的变化,初步评价脾次全切除术在门脉高压症中的作用。方法:建立肝硬化门脉高压症大鼠模型,大鼠腹部皮下注射60%四氯化碳(CCl4)0.3ml/100g油溶液,同时10%乙醇溶液代替饮水,测量门静脉压≥12mmHg及病理学证实模型成功。对各组进行血常规、免疫球蛋白、T淋巴细胞亚群的测定及HE染色组织学观察。结果:保留约正常脾脏大小的脾部分切除组与正常对照组术后血常规、免疫球蛋白和T淋巴细胞亚群的水平无显著性差异。保留约正常脾脏大小的脾部分切除组肝纤维化程度减轻;脾包膜变薄,脾实质轻度充血。结论:门脉高压症的残余脾脏具有一定的生理功能;保留约正常脾脏大小的脾部分切除术在一定程度上能够维持机体的体液免疫和细胞免疫。Objective：To detect the changes of cellular and humoral immunity after subtotal splenectomy in rats with portal hypertension （PHT）, and to evaluate the role of subtotal splenectomy for treating portal hypertension. Methods：The rat model of cirrhotic PHT was established by hypodermic injection of 60% carbon tetrachloride （CCl4） oil solution （0.003 ml/g） into the abdomen and by replacing the drinking water with 10% alcohol solution. The portal vein pressure ≥ 12 mmHg and pathologieal changes indicated that the rat model was established successfully. The blood routine, determination of immunoglobulin and T lymphocyte subgroups, and HE staining were performed. Results： There were no significant differences in the results of blood routine and the levels of immunoglobulin and T lymphocyte subgroups between normal control group and partial splenectomy group in which the size of residual spleen is almost the same as that of normal spleen. The degree of liver fibrosis was less severe in partial splenectomy group in which the size of residual spleen is almost the same as that of normal spleen. Conclusion：The residual spleen after partial splenectomy in rats with portal hypertension has physiological function to some extent. The residual spleen whose size is almost the same as that of normal spleen after partial splenectomy could maintain the cellular and humoral immunity.

关 键 词：脾次全切除术 门脉高压症 

分 类 号：R657.3[医药卫生—外科学]