门静脉转流下大鼠耐受入肝血流阻断安全时限的实验研究  

EXPERIMENTAL STUDY ON THE TOLERANCE OF NORMOTHERMIC HEPATIC INFLOW OCCLUSION WITH PORTAL BLOOD BYPASS IN RAT

作　　者：何效东[1] 董家鸿[2] 蔡景修[2] 李昆[2] 段恒春[2] 韩本立[2] 

机构地区：[1]解放军第一医院肝胆外科中心,研究生兰州730030 [2]第三军医大学西南医院肝胆外科中心,重庆400038

出　　处：《中国普外基础与临床杂志》2000年第4期220-223,共4页Chinese Journal of Bases and Clinics In General Surgery

摘　　要：目的　探讨大鼠常温下耐受入肝血流阻断的最大安全时限。方法　用自行设计的可避免门静脉瘀血的动物模型 ,通过动物 7天存活率、肝脏能量代谢改变的可逆性进行分析。结果　在门静脉转流 (portalveinbloodbypass ,PBB)下 ,大鼠耐受持续入肝血流阻断的时间显著延长 ,肝缺血 90分钟恢复灌流后 7天 ,动物全部存活 ,而缺血 10 0、110、12 0分钟及单纯入肝血流阻断 (portaltriadclamping ,PTC) 30分钟者存活率分别为 5 0 %、30 %、2 0 %及 40 % ;肝脏能量代谢改变在缺血不超过 90分钟者是可逆的 ,而缺血 12 0分钟及单纯入肝血流阻断 30分钟者则演变为不可逆。结论　门静脉转流下大鼠耐受持续肝血流阻断的安全时限是Objective To investigate the maximum tolerance limit of rats to hepatic inflow occlusion with portal vein blood bypss (PBB) in normothermia. Methods [WT5”BZ]First. A new animal model was established, the animal survival rate were calculated following 7 days of reperfusion after hepatic inflow occlusion of 30, 60, 90, 100, 110, 120 min or portal triad clamping (PTC) of 30 min. And then, the hepatic energy metabolism (RCR, P/O, ATP, AKBR) was studied following 30, 90, 120 min of ischemia or 1, 6, and 24 hours of reperfusion after the ischemia. According to the reversibility of the hepatic motochondrial function injury and maximum as long as a period of liver warm ischemia of all animal postoperative 7 days survial, the safe limit of rat to hepatic inflow occlusion was evaluated. [WT5”HZ]Results [WT5”BZ]The survival rate on postoperative 7 days was one hundred percent subjected to 30, 60 and 90 min of hepatic inflow occlusion, and 50, 30, 20 percent in 100, 110, 120 min, respectively, the survival rate in rats with 30 min of portal triad champing was about 40 percent. The parameters of hepatic motochondrial function reflecting the degree of liver damage to ischemia showed significantly different as compared to sham group. The functional lesion was exacerbated during inital reperfusion, then was restored progressively in PBB 30 min and PBB 90 min groups, but was maintained low level in PBB 120 min and PTC 30 min groups. [WT5”HZ]Conclusion [WT5”BZ]The 90 minutes is the maximum limit of rats to hepatic inflow occlusion in normothermia.

关 键 词：大鼠 门静脉瘀血 肝血流阻断术 安全时限 

分 类 号：R657.3[医药卫生—外科学]