肝动脉结扎联合门静脉部分阻断对肝再生及肝细胞癌生长的影响  

Effect on liver hyperplasia and hepatocellular carcinoma growth after liver arterial ligation combined with partial portal ligation

作　　者：潘乐玉[1] 郭德良[1] 张玉仙 杨卫华[1] 王志刚[1] PAN Leyu;GUO Deliang;ZHANG Yuxian(Department of Hepatopancreatobiliary Surgery,Jingmen First People's Hospital,Hubei Province,Jingmen 448000,China)

机构地区：[1]湖北省荆门市第一人民医院肝胆胰外科Ⅰ病区,448000

出　　处：《临床外科杂志》2021年第4期367-371,共5页Journal of Clinical Surgery

基　　金：湖北省自然科学基金资助项目(2016CFC731)。

摘　　要：目的观察结扎裸鼠患侧肝动脉并部分阻断患侧门静脉血流对保留侧肝脏再生及患侧肿瘤生长的影响。方法取健康4周龄裸鼠,建立裸鼠肝细胞肝癌模型,120只随机分为4组:空白对照组30只(sham),患侧肝动脉结扎组30只(hepatic artery ligation,HAL),患侧部分门静脉阻断组30只(partial portal vein ligation,pPVL),患侧肝动脉结扎联合患侧部分门静脉阻断组30只(HAL+pPVL)。分别做相应处理后,在不同的时间点观察血清生化指标、保留肝脏再生率、肿瘤大小及肿瘤周围微血管侵犯(microvascular invasion,MVI)。结果pPVL+HAL组死亡1只,在72小时内,pPVL组死亡1只,在术后24小时内。丙氨酸氨基转移酶(ALT)及门冬氨酸氨基转移酶(AST)浓度水平在术后24小时及72小时,pPVL组及HAL+pPVL组较Sham组高,差异有统计学意义(P<0.05)。在术后72小时,1周,2周以及3周,pPVL组及HAL+pPVL组保留侧肝脏质量与Sham及HAL组比较,差异有统计学意义(P<0.05)。在术后1周,2周及3周,HAL组及pPVL+HAL组肿瘤体积与pPVL组及Sham组比较,差异有统计学意义(P<0.05)。将Sham组与pPVL组合并为对照组,HAL组与HAL+pPVL组合并为实验组,MVI阳性率在术后3周实验组与对照组比较,差异有统计学意义(P<0.05),且实验组术后3周与术后2周比较差异有统计学意义(P<0.05)。结论HAL+pPVL可促进保留侧肝脏代偿增生的同时在一定时间内可抑制肿瘤的生长。Objection To observe the effect on naked mice,sliver hyperplasia and hepatocellular carcinoma growth after liver arterial ligation combined with partial portal ligation.Methods To take healthy 4-week-old naked mice,establish hepatocellular carcinoma models,divide 120 naked mice into 4 groups randomly:control group(Sham n=30);partial portal vein ligation group,(pPVL n=30),hepatic artery ligation group(HAL n=30),HAL combined with pPVL group(HAL+pPVL n=30).After corresponding treatment,serum biochemical indexes,preserved liver regeneration rate,tumor size and surrounding microvascular invasion were observed at different time points.Result One naked mouse dead in pPVL+HAL group in 72 h,also one naked mouse in pPVL group dead in 24 h.The ALT and AST levels of pPVL group and HAL+pPVL group was significantly different from that of Sham group at 24 h and 72 h after operation(P<0.05).The preserved side liver quality of PVL group and HAL+pPVL group was significantly different from that of Sham group and HAL group at 72 h,1 W,2 W,3 W after operation(P<0.05).The tumor volume of HAL group and HAL+pPVL group was significantly different from that of PVL group and Sham group at 1 W,2 W and 3 W after operation(P<0.05).The Sham group and PVL group were combined as the control group,and the HAL group and HAL+pPVL group were combined as the experimental group,The positive rate of MVI in the experimental group was significantly different from the control group at 3 W after operation(P<0.05),and also that was significant difference between 2 W and 3 W after operation in the experimental group(P<0.05).Conclusion HAL+pPVL could promote the growth of preservated liver hyperplasia and inhibit the growth of tumor in a short period of time,which provides a new treatment for some patients with advanced hepatocellular carcinoma.

关 键 词：肝细胞肝癌 肝动脉结扎 门静脉部分阻断 动物实验 

分 类 号：R735.7[医药卫生—肿瘤]