一种新的可逆型梗阻性黄疸兔模型的建立  

Establishment of a novel reversible rabbit model of obstructive jaundice

作　　者：周春献[1] 徐东风[1] 陈钟[2] 

机构地区：[1]南通大学附属吴江医院介入科,吴江215200 [2]南通大学附属医院普外科

出　　处：《南通大学学报（医学版）》2014年第4期267-270,F0003,共5页Journal of Nantong University(Medical sciences)

摘　　要：目的 :建立一种能简便实行胆汁内外引流的可逆型梗阻性黄疸兔模型。方法 :新西兰大白兔36只,随机分为3组,胆汁外引流组(A组,n=12)、胆汁内引流组(B组,n=12)及假手术组(C组,n=12)。A、B组采用切断胆总管后分别向肝与十二指肠方向插入硅胶管,两端缝扎固定,夹闭器夹闭硅胶管并缝于皮下的方法建立可逆型梗阻性黄疸模型,造模后第7天再次手术,剪断硅胶管引至体外形成胆汁外引流,去除夹闭器后恢复胆汁内引流;C组采用分离胆总管后打松结的方法作为对照。所有兔于造模前、造模后第7天、再次手术后第7天时采血检测肝功能指标,B超检查肝胆系统;再次手术后第7天取肝脏组织标本作病理学检查。结果:成功建立了可逆型梗阻性黄疸模型。造模前A、B、C 3组间总胆红素(total bilirubin,TB)、直接胆红素(direct bilirubin,DB)、谷丙转氨酶(alanine transarninase,ALT)、γ-谷氨酰转肽酶(γ-glutamyl transferase,γ-GT)差异无统计学意义(均P>0.05);造模后第7天A、B两组TB、DB、ALT、γ-GT较造模前明显增高(均P<0.05),明显高于C组(P<0.05);再次手术后第7天A、B两组TB、DB、ALT、γ-GT较造模后第7天明显下降(P<0.05),A、B、C 3组间差异无统计学意义(P>0.05)。造模后第7天,B超下可见A、B两组肝脏弥漫性肿大,胆囊增大,肝内胆管、肝总管明显扩张;再次手术后第7天,B超下可见A、B两组肝脏无明显肿大,胆囊萎缩,肝内胆管、肝总管无明显扩张。再次手术后第7天,A组肝小叶结构基本恢复正常,肝窦轻度扩大,汇管区少量炎症细胞浸润伴纤维组织增生;B组汇管区无明显炎症细胞浸润。结论:研究建立的可逆型梗阻性黄疸模型具有可靠有效,可重复性强,再通时操作简单等特点,值得在梗阻性黄疸和胆汁内外引流实验中推广。Objective： To establish a reversible rabbit model of obstructive jaundice which was easy to execute internal and external biliary drainage. Methods：36 New Zealand rabbits were randomly divided into three groups：external biliary drainage group（group A）, internal biliary drainage group（group B） and sham operation group（group C）. In groups A, B, reversible rab-bit model of obstructive jaundice was established, including cutting off common bile duct, putting silica gel duct in hepatic and duodenal ends, fixing both ends by suturing, occluding silica gel duct and then subcutaneously sewing. Rabbits were subjected with operation again at the 7th day postoperatively： external biliary drainage was formed by shearing off silica gel duct and puting vitro, and internal biliary drainage was formed by removing occlusion. In sham operation group, rabbits were subjected with liberating common bile duct and making loose knot. Blood of all animals was collected preoperatively , at 7th day postoperatively and 7th day after second operation. Liver function was detected by automatic biochemistry analyzer. Liver and bile duct were observed by ultrasound postoperatively and at 7th day postoperatively and 7th day after second operation. Liver tissue was collected at 7th day after second operation , and the pathology of liver was observed. Results： The reversible rabbit model of obstructive jaundice was established. There was no significant difference in liver function of groups A, B, C postoperatively. The level of total bilirubin （TB）, direct bilirubin （DB）, alanine transarninase（ALT） andγ-glutamyl transferase （γ-GT） were higher in groups A, B than those in groups A, B preoperatively and group C at 7th day postoperatively. At 7th day after second operation, the level of TB, DB, ALT and γ-GT after internal and external drainage in groups A, B were decreased, and there was no significant difference in groups A, B, C. It was shown that liver enlarged diffusely, gallbladder enlarged, intra-hepatic

关 键 词：梗阻性黄疸 胆汁内引流 胆汁外引流 动物模型 

分 类 号：R657.4[医药卫生—外科学]