搏动性门脉血泵治疗门脉高压症的实验研究  

An experimental study on a pulsation-type portal pump in the treatment of portal hypertension

作　　者：曹罡[1] 刘清峰[1] 刘效恭[1] 

机构地区：[1]西安交通大学第二医院普外科,710004

出　　处：《肝脏》2001年第4期244-246,共3页Chinese Hepatology

摘　　要：目的　为解决门脉高压症向肝血流减少、肝代谢功能下降及侧支循环压力过高、静脉曲张等问题 ,我们研制了搏动性门脉血泵 ,对丝线栓塞性门脉高压模型犬进行门脉外动力泵血的研究。观察入肝血量、肝代谢变化及侧支压力等一系列指标。方法　对杂种犬进行门脉左右支丝线栓塞术制备门脉高压动物模型 ;应用高弹力硅胶球囊连接单流向硅胶瓣“T”型管 ,制作搏动性门脉血泵 ;应用强磁场磁极片及低频振荡交流线圈体外提供动力。将血泵“T”管安置于门脉主干前壁侧支平面上 ,测定血泵工作前后的入肝血流量、侧支静脉压力及吲哚氰绿排泄的变化。结果　模型犬血泵平面以上的门脉压力在泵工作后由 ( 30 .3± 4.2 )cmH2 O升至 ( 4 9.0± 7.1)cmH2 O ;入肝血流量由 ( 2 70± 2 8)ml/min升至( 396± 2 5 )ml/min ;血泵平面以下门脉压由 ( 31.4± 3.1)cmH2 O降至 ( 18.0± 4.3)cmH2 O ;脾静脉压由 ( 36 .2± 4.0 )cmH2 O降至 ( 2 0 .5± 3.4)cmH2 O ;胃底静脉压由 ( 35 .3± 3.3)cmH2 O降至 ( 19.3± 4.7)cmH2 O ;吲哚氰绿排泄率由 ( 0 .0 92± 0 .0 0 9)升至 ( 0 .15 1± 0 .0 13) ;15min滞留率由 ( 19.0 3± 8.5 0 )降至 ( 9.0 4± 2 .5 0 )。结论　搏动性门脉血泵对增加门脉入肝血流 。Objective In order to treat decreased portal inflow, decreased metabolic function and varicosis in portal hypertensive patients, a pulsation-type portal pump was designed and used in the treatment of canine model of portal hypertension, induced by thread embolization in the portal vein. Methods Thread were placed into both left and right branches of the portal vein and portal hypertension developed two weeks after. A pulsation-type portal pump was constructed with a silica rubber balloon and a T shaped silica rubber tube which has two valves at the tips allowing the blood flow in one direction. The pulsation of the balloon was caused by a pair of plates. One stainless steel plate was fixed on one side of the ballon while the other made of a strong magnetic steel were fixed on the other side. The power was supplied by a low frequency alternating magnetic field which is placed outside the abdomen. The T shaped tip of the pump was than placed into the portal vein at the point above the major collateral branches. The blood pressure and flow of the portal system were measured as well as the liver metabolic function. Results Pump working, the blood pressure above the pump increased from (30.3±4.2)cm H 2O to (49.0±7.1)cm H 2O whereas the pressure below the pump decreased from (31.4±3.1)cm H 2O to (18.0±4.3)cm H 2O, and the blood inflow of the liver increased from (270±28)ml/min to (396±25)ml/min. The pressure of the spleen vein decreased from (36.2± 4.0)cm H 2O to (20.5±3.4)cm H 2O and the pressure of the gastric fundal vein decreased from (35.3±3.3)cm H 2O to ( 19.3±4.7)cm H 2O. The ICGK increased from (0.092±0.009) to (0.151±0.013) while the ICGR 15 decreased from (19.03± 8.50) to (9.04± 2.50).Conclusion The pulsation-type portal pump significantly increased the blood inflow and the metabolic function of the liver, and decreased the blood pressure of the portal system. More work is needed to make the device to be applicable in clinical practice.

关 键 词：门静脉高压症 门脉血泵 动物模型 

分 类 号：R657.3[医药卫生—外科学]