保留半肝动脉血供肝血流安全阻断时限的研究  

Maximum tolerance of selective hemihopatic vascular occlusion

作　　者：穆振国[1] 王新伟[1] 王洪远[1] 梁静雅[1] 李建新[1] 张林[1] 曹广涛[1] 

机构地区：[1]日照市中医医院普外科,山东日照276800

出　　处：《中国肿瘤外科杂志》2011年第5期269-272,共4页Chinese Journal of Surgical Oncology

摘　　要：目的探讨门静脉自然转流及非转流情况下保留半肝动脉血供肝血流阻断的安全时限。方法将实验用雄性Wistar大鼠随机分为A、B、C组。A组保留肝左、肝中动脉血供及尾状叶动脉、门静脉血供(约占全肝5%),夹闭肝左、肝中叶门静脉,结扎肝右叶肝蒂,到预定阻断时相点,恢复肝脏灌流,切除肝右叶及尾状叶,24 h后检测ALT、肝脏HE染色(细胞核)阳性面积的平均百分数及术后7d存活率。B组不保留尾状叶动脉及门静脉血供,其他与A组相同。C组完全阻断肝脏入肝血流,肝切除方式及检测指标与A组相同。结果在A、B、C三组中,A组的阻断形式对肝脏的损害最轻,B组次之,C组最重。A/100、B/40与C/20损害程度相当。结论大鼠门静脉转流下保留半肝动脉血供入肝血流阻断的安全时限是100 min,单纯保留半肝动脉血供入肝血流阻断组的安全时限是40 min。Objective To investigate the maximum tolerance of selective hemihopatic vascular occlusion with portal vein blood natural bypassing or not. Methods Wistar rats were divided into 3 groups： The rats in the A group remained the blood supply of the left and middle hepatic artery, and the artery and the portal vein of caudate lobe （ about 5% in total hepatic blood supply） clamped the portal vein of left and middle lobe of liver, ligated the hepatic pedicle of the right lobe of liver, then recovered the perfusion of liver at the scheduled time, and cut the right and caudate lobe of liver at last. Detected the number of ALT, the average percentage of liver HE positive staining area （nucleus） after 24 hours, and the 7 days postoperative survival rate. The rates in the B group didn＇t remain the artery and the portal vein of caudate lobe, and the C group rates blocked the hepatic inflow completely. The 3 groups were with the same in the liver resection and the detection index. Results The rat livers in A group are injured lightest in the three groups, and the B group is lighter than the C group. The extent of the damage of A/100, B/40 and C/20 is in the same level. Conclusions The 100 minutes is the maximum tolerance of rats to selective hemihopatic vascular occlusion with portal vein blood natural bypassing, and the 40 minutes is the maximum tolerance of rats to simple selective hemihopatic vascular occlusion.

关 键 词：肝切除术 保留半肝动脉血供 门静脉转流 肝血流阻断 安全时限 WISTAR大鼠 

分 类 号：R657.3[医药卫生—外科学]