阻断肝右静脉对肝硬化小猪肝脏血流动力学的影响  

Changes of Hepatic Hemodynamics of Pigs with Liver Cirrhosis by Permanent Ligation or Intermittent Obstruction of Right Hepatic Vein

作　　者：罗葆明[1] 周忠信[2] 王捷[2] 潘景升[1] 马健鸿[1] 戴晓宁[1] 

机构地区：[1]中山医科大学孙逸仙纪念医院超声科,广州市510120 [2]中山医科大学孙逸仙纪念医院外科,广州市510120

出　　处：《中国超声医学杂志》2002年第1期1-5,共5页Chinese Journal of Ultrasound in Medicine

摘　　要：目的 :探索肝硬化条件下合理的肝静脉阻断方式。方法 :分别缝扎或间歇阻断肝硬化小猪各 6头 ,动态观察肝脏组织病理学、肝功能、肝动脉造影、核素扫描和肝脏血流动力学的改变。结果 :缝扎组早期肝损害明显 ,6周后恢复 ;早期肝右叶肿胀淤血 ,晚期有萎缩 ;左叶横径纵径增加 ;术后门静脉压力升高 ,门静脉血流减慢、流量减少 ;肝动脉血流加快、血流量增加 ;肝动脉 -门静脉瘘、右肝门静脉分支与左肝静脉分支交通支形成。间歇阻断组肝损害较轻但持久 ,阻断期肝右叶肿胀 ,放松后改善 ;6周后左叶略增大 ,右叶减小不明显 ;阻断期 PVP、门静脉、肝动脉血流速度、血流量改变与结扎组相似 ,间歇期恢复 ;未见血管瘘形成。结论 :肝硬化情况下缝扎 RHV致肝右叶萎缩、左叶代偿增生较间歇阻断组明显 ;缝扎 RHV致肝功能损害早期较明显 ,可自行恢复 ,间歇阻断致肝功能损害较轻但持久 ;缝扎 RHV对肝脏血流动力学的影响较明显 ,肝内侧支循环较完善。Objective:To search the proper ways of obstructing hepatic vein based on liver cirrhosis.Methods:On basis of cirrhosis,12 pigs were separated into two groups randomly,6 pigs were group A(the right hepatic vein was ligated permanently)and 6 pigs were group B(the right hepatic vein was obstructed intermittently).Pathology,liver function,and hemodynamics of pigs were observed.Results:In group A,liver function was impaired early and resumed 6 weeks after operation.The liver swelled early and shrinked after 9 weeks.The diameter of the left liver was increased.Portal vein pressure(PVP)was increased.The velocity and flow of portal vein were decreased.While the velocity and flow of hepatic artery were increased.A V shunts and collateral branches were formed from right to left lobe of the liver.In group B,liver damage was light but durative.The right liver swelled when obstructed early and shrinked little after 9 weeks.The left liver was augmented slightly after 6 weeks and PVP increased when obstructed and decreased in intermission.The changes of velocity and flow of portal vein and hepatic artery in group B were likely in group A when right hepatic vein was obstructed and the flow resumed in intermission.No A V shunts were found.Conclusions:When the right hepatic vein was ligated permanently,the right liver lobe was more significantly shrinked and the left lobe was hyperplastic.Liver function was seriously impaired early but resumed automatically later.A V shunts and collateral branches were observed.When the right hepatic vein was obstructed intermittently the liver damage was light but durative,A V shunts and collateral branches were not observed.

关 键 词：中国小型猪 肝硬化 组织病理学 血流动力学 肝静脉 彩色多谱勒超声 

分 类 号：R575.2[医药卫生—消化系统]