门静脉联合胆管双结扎与单纯门静脉结扎对非结扎侧肝增生的影响  

Effects of double ligation of portal vein and bile duct and single ligation of portal vein on the hypertrophy in the non-ligated liver lobe

作　　者：潘立超[1] 任为正[1] 葛新兰[1] 张东欣[1] 柏佳[1] 董家鸿[1] 

机构地区：[1]解放军总医院肝胆外科,北京100853

出　　处：《中国现代普通外科进展》2015年第4期253-258,共6页Chinese Journal of Current Advances in General Surgery

基　　金：国家传染病重大专项课题(2012ZX10002-017)

摘　　要：目的:探讨胆管联合门静脉双结扎(B PL)与单纯门静脉结扎(PVL)对非结扎侧肝增生的影响。方法:健康清洁级雄性SD大鼠72只随机分为B PL组和PVL组,每组36只。解剖大鼠肝门部,B PL组结扎大鼠肝左、中叶门静脉和胆管,PVL组结扎大鼠肝左、中叶门静脉。在术后0、1、2、3、5和7 d分别将各组大鼠称重后取下腔静脉血、肝组织,测定血清以及肝内胆汁酸水平,测定转氨酶水平,称量未结扎侧和结扎侧肝重。对于非结扎侧肝脏,W estern blot测定PC N A表达量,免疫组织化学检测ki67阳性细胞指数。结果:两组术后均引起一过性转氨酶升高。B PL组肝内胆汁酸于术后1 d升至峰值,随后迅速降低。而PVL组肝内胆汁酸于术后2 d到达峰值,随后缓慢降低。PC N A表达量以及ki-67阳性细胞指数B PL组均比PVL组提前到达峰值。PVL与B PL均可以引起肝脏萎缩-增生综合征(A H C)。但是,B PL更快、更有效。结论:B PL比PVL能更有效地促进非结扎侧肝叶的增生。Objeetive：To explore the effects of double ligation of portal vein and bile duct and single ligation of portal vein on the Hypertrophy in the non-ligated liver lobes.Metkods：72 healthy Sprague-Dawley rats （clean grade） were randomly divided into 2 groups：bile duct and portal vein ligation group（BPL group）and portal vein ligation group（PVL group）with 36 rats in each group.From the hilus of the liver,portal veins in the left lobe and middle lobe as well as the bile duct were ligated in rats of the BPL group,and only portal veins in the left lobe and middle lobe were ligated in rats of the PVL group.At 0,1,2,3,5,7 days after the operation,the rats were weighed and then the inferior vena caval blood and liver tissues were harvested to determine bile acid levels in serum and the liver,to measure aminopherase indexes and to weigh both ligated and non-ligated lobes.For the non-ligated lobes,Western Blot was employed to measure the level of expression of PCNA and calculate Ki-67 labeling index based on immunohistochemistry.Results：A flare-up in aminopherase was detected in both groups.For the BPL group,the bile acid in liver peaked at Day1 after the operation and then decreased sharply.For the PVL group,however,the bile acid in liver hit the peak at Day2 and then went down smoothly.Both the level of expression of PCNA and the ki-67 labeling index in BPL group peaked in a shorter time compared with those in the PVL group.Even though BPL and PVL could both lead to the AHC of the liver,BPL was faster and more effective.Conclusion：Compared with PVL,BPL is more effective in inducing hyperplasia of the non-ligated liver lobes.

关 键 词：胆管结扎 门静脉结扎 肝再生 PCNA ki-67 

分 类 号：R657.3[医药卫生—外科学]