腹腔神经丛阻滞对大鼠肝部分切除术后残肝炎症反应的影响  

The effect of neurolytic celiac plexus block on liver inflammatory reaction after partial hepatectomy in rats

作　　者：邹洪[1] 李军[2] 崔建峰[1] 闫洪涛[1] 陈涛[1] 石力[1] 汤礼军[1] 

机构地区：[1]成都军区总医院普外中心,成都610083 [2]成都军区总医院麻醉科,成都610083

出　　处：《中华肝胆外科杂志》2014年第6期454-456,共3页Chinese Journal of Hepatobiliary Surgery

摘　　要：目的观察腹腔神经丛阻滞（NCPB）对大鼠肝部分切除术（PH）后残存肝组织炎症反应及肝功能的影响。方法30只SPF级雄性SD大鼠分别用肝左叶、中叶根部结扎切除构建经典大鼠PH模型。动物随机平均分为NCPB组和对照组。前者在术后12h开始给予双侧0．5％利多卡因经皮NCPB，对照组则以0．9％生理盐水替换，1次／d。术后第1、3、7天行NCPB后30min取材，分别测定肝功能、观察残肝增殖情况及病理切片免疫组织化学染色观察IL-β、TNF-α的沉积情况。结果NCPB组大鼠的天冬氨酸转氨酶和丙氨酸转氨酶在PH术后第1天、3天、7天均不同程度地低于对照组（P〈0．05），总胆红素在第7天显著低于对照组（P〈0．01），白蛋白在第3、7天显著高于对照组（P〈0．01）。对照组与NCPB组残肝增殖情况（切除肝重量和术毕残余肝重量）差异无统计学意义。PH术后3d、7d，NCPB组残肝组织切片炎症因子IL—β、TNF-α的表达情况均显著低于对照组。结论NCPB能减轻大鼠PH术后肝功能损害，减少残余肝组织的炎症因子表达。Objective To investigate the effect of neurolytic celiac plexus block （NCPB） on the inflammatory reaction of the remaining liver tissue and liver function after partial hepatectomy （PH） in rats. Methods Thirty male Sprague-Dawley rats of SPF were constructed as a PH model with deligation and ablation operated on their left and middle lobes, respectively. Then, they were randomly divided into two groups： NCPB group and control group. Twelve hours after the surgery, 0. 5% lidocaine was given in the NCPB group once a day, while 0. 9% saline was given in the control group. Determination of liver function, generation of the remaining liver, and deposition of IL-β, TNF-α of the pathological section was respectively made on Day 1, 3 and 7 after the surgery. Results On Day 1, 3 and 7 after surgery, both the aspartate aminotransferase （AST） and the alanine aminotransferase （ALT） levels in NCPB group were, to different degrees, lower than those in the control group （ P 〈 0. 05）. Strikingly, total bilirubin in NCPB group was lower than that in control group （P 〈0. 01 ） on Day 7, while the level of serum albumin was higher than that in control group （P 〈 0. 01 ）. There was no statistically significant difference on the generation of the remaining livers between NCPB and control groups. On Day 3 and 7, the deposition of IL-β, TNF-α in the pathological sections of NCPB group were lower than those in control group. Conclusion NCPB can not only effectively reduce the damage of liver function caused by PH surgery, but also improve the inflammatory reaction of the residual liver.

关 键 词：腹腔神经丛阻滞 肝部分切除术 炎症反应 

分 类 号：R657.3[医药卫生—外科学]