幼猪体外肝叶切除自体余肝原位再植术中氧供需平衡的研究  

Experimental study of oxygen supply and demand balance during total hepatectomy and partial liver replantation with venous bypass technique in young pigs

作　　者：程智刚 郭曲练 申建初 谭秀娟 杨连粤 吕新生 

出　　处：《湖南医科大学学报》1999年第4期322-324,共3页Bulletin of Hunan Medical University

基　　金：卫生部青年基金

摘　　要：目的：研究体外肝叶切除自体余肝原位再植术对机体氧供需平衡的影响。方法：７ 只健康幼猪，麻醉后分别经脾静脉插管至门静脉和右股静脉插管至下腔静脉，两管经 Ｙ 型管联接，右颈内静脉插管至右心房，全肝血流阻断时建立门腔心房体外辅助循环。在麻醉后、转流３０ ｍｉｎ 及转流后３０ ｍｉｎ 分别测定血流动力学指标、混合静脉血氧饱和度（ Ｓ珔ｖ Ｏ２） 及血气分析。结果：①术中 Ｓ珔ｖ Ｏ２ 显著降低（ Ｐ ＜ ０ ．０５） ；②静脉转流能部分纠正术中血流动力学紊乱；③心输出量与 Ｓ珔ｖ Ｏ２ 存在相关关系。结论：提示体外肝叶切除自体余肝原位再植术中存在氧供需状态的失衡。To investigate the changes of oxygen supply and demand balance during total hepatectomy and partial liver replantation(TCH and PLRP) with venous bypass technique in pigs. Methods: Seven young pigs〔weight (24.2±4.8)kg〕 were anesthetized with fentanyl and pentobartal. Catheters were inserted into portal vein via splenic vein and into vena cava inferior via right femoral vein, respectively, and the two catheters were connected by a “Y” adaptor to right atrium via extracorporeal circulation pump. Venous bypass technique was used during occlusion of total hepatic blood stream(OTHB). SO 2, hemodynamics and blood gas analysis were measured after anesthesia, during and 30 mintues after venous bypass. Results: SO 2 was decreased significantly(P<0.05), vein bypass technique ameliorated partially the disturbance of hemodynamics, and there was correlation between CO and SO 2 during THC and PLRP in pigs. Conclusion: The results suggest that there is oxygen supply and demand unbalance during THC and PLRP with venous bypass technique in pigs, and it is beneficial to monitor oxygen ladder during operation.

关 键 词：肝切除术 肝移植 氧消耗 猪 

分 类 号：R657.3[医药卫生—外科学]