显微外科技术建立稳定的大鼠梗阻性黄疸内引流模型  

A stable rat model of obstructive jaundice reversed by internal bile drainage using microsurgical techniques

作　　者：刘涵生 饶浩高[1] 徐清华 李崇辉 张爱群[2] 潘成军[1] 董家鸿 LIU Han-sheng;RAO Hao-gao;XU Qing-hua;LI Chong-hui;ZHANG Ai-qun;PAN Cheng-jun;DONG Jia-hong(The Hospital Affiliated to Troop 61016 of Chinese PLA,Beijing 102202,China;Research Institute of Hepatobiliary Surgery,Chinese PLA General Hospital,Beijing 100853,China;Department of Ultrasonography,China-Japan Friendship Hospital,Beijing 100029,China;Beijing Tsinghua Changgung Hospital,Beijing 102218,China)

机构地区：[1]解放军61016部队医院 [2]解放军总医院全军肝胆外科研究所 [3]中日友好医院超声科 [4]北京清华长庚医院

出　　处：《中国现代普通外科进展》2017年第11期845-850,855,共7页Chinese Journal of Current Advances in General Surgery

摘　　要：目的:利用显微外科技术建立一个稳定的大鼠梗阻性黄疸内引流模型。方法:所有操作均在手术显微镜下进行。第1次开腹结扎近端胆总管,往胰腺端胆总管插入引流管约3 mm长,引流管远端封闭,建立黄疸模型;7天后第2次开腹,引流管开放后置入近端扩张的胆总管,实现近端胆管和胰胆管架桥。检测引流前后大鼠营养状况、肝重、肝脏和胰腺生化、肝脏病理和超声弹性成像等,评估新型模型的稳定性。结果:未见肠道返流、胆管堵塞等并发症。建立黄疸模型后第1天,有2例大鼠血清淀粉酶和脂肪酶升高,第4天及以后均未发现胰腺酶谱升高。胆道内引流后血糖和血清白蛋白较快恢复到正常水平;肝重/体重上升;各项生化指标、肝脏超声弹性模量值、肝脏病理改变逐渐恢复到正常水平。结论:采用显微外科技术,成功建立了一个新型稳定的大鼠梗阻性黄疸内引流模型。Objective:To better understand the pathogenesis of obstructive jaundice(OJ),a variety of rat OJ and biliary drainage models have been tried;however,complications are still common.We aimed to establish a stable rat model of OJ using microsurgical techniques,and to assess its reversal by internal bile drainage(IBD).Methods:After the pilot study,we developed a standardized surgical procedure.All operations were carried out under an operating microscope.In the first laparotomy,the proximal common bile duct(CBD)of the rat was ligated and transected.A tube was introduced into the distal end of the duct,and the other end of the tube was sealed and fixed.In the second laparotomy,the drainage tube was inserted into the(by nowmarkedly dilated)proximal CBD,and ligated into position.We evaluated the general condition of the rats,the status of the liver and pancreas before and after IBD.Results:Complications such as intestinal reflux and bile duct blockage,were not found.Pancreatic injury was not evident by day 4 after the first laparotomy.After biliary drainage,the serum glucose and albumin concentration rapidly returned to normal levels.Liver weight/body weight ratio increased.The biochemical indicators and ultrasonographic elastography results for the liver gradually returned to normal.Conclusion:Using microsurgical techniques,we have developed a stable rat model of OJ reversed by IBD.

关 键 词：梗阻性黄疸 显微外科 内引流 超声弹性成像 

分 类 号：R735.8[医药卫生—肿瘤]