门腔静脉侧侧分流加肝动脉强化灌注对肝硬变肝脏影响的实验研究  

The influence of sidetoside portacaval shunt plus enhancement of perfusion of hepatic artery on cirrhotic liver:an experimental study

作　　者：翁以炳[1] 王宇[1] 薛建国[1] 张忠涛[1] 周延忠[1] 陈道荫[1] 李春林[1] 

机构地区：[1]首都医科大学附属北京友谊医院普外科

出　　处：《中华外科杂志》1998年第8期487-490,共4页Chinese Journal of Surgery

摘　　要：目的门腔分流术严重影响肝脏血循环，为改善术后肝供血，设计并进行了门腔分流加肝动脉强化灌注术的实验研究。方法４８只Ｗｉｓｔａｒ大鼠被随机均分为：正常对照组（Ⅰ组），肝硬变对照组（Ⅱ组），肝硬变分流组（Ⅲ组），肝硬变分流加肝动脉强化灌注组（Ⅳ组）；行肝功能检查，肝活检及核素动态肝胆显像。结果Ⅳ组较Ⅲ组肝功能明显改善（Ｐ＜００５）。核素显像：高峰时间提前（Ｐ＜００５）；排泄率增高（Ｐ＜００１）。光镜：肝纤维结缔组织增生减轻（Ｐ＜００５）。电镜：肝纤维化程度减轻。结论该术式通过强化肝动脉灌注增加肝血供，相对增加肝营养因子的供给，对肝功能有一定维护作用，减轻术后肝纤维化程度；一定程度上克服了门腔分流术和断流术的不足，有望成为治疗门静脉高压症的新的实用术式。Objective To for improving the perfusion of liver, we designed an operation of portacaval shunt (PCS) plus enhancement of perfusion of hepatic artery (EPHA). Method 48 wistar rats were devided into 4 groups randomly. groupⅠ(normal control), groupⅡ(liver cirrhotic control), groupⅢ(PCS on liver cirrhosis), and groupⅣ(PCS+EPHA on liver cirrhosis). The EPHA was performed by the ligation of the left gastric and splenic artery. Liver function tests, liver biopsy, and nuclide hepatobiliary dynamic imaging(NHDI) were performed on the 2nd week and the 6th month after operation. Result In NHDI, the peak time was short(P<005) and the excretive rate was high(P<001). The liver function and the proliferative degree of the fibrotic tissue of the liver were perfected significantly(P<005) in the group Ⅳ compared with the group Ⅲ after operation.Conclusion PCS+EPHA can increase the perfusion of the hepatic artery, maintain the liver function and delay liver cirrhosis, and overcome the side effects of PCS. It is a new surgical techniqe in treating portal hypertension.

关 键 词：门腔分流术 肝硬化 实验 门脉高压症 

分 类 号：R657.31[医药卫生—外科学] R657.34[医药卫生—临床医学]