搏动性门静脉血泵治疗门静脉高压症的实验研究  

Application of pulsation-type portal pump in 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,西安市710004

出　　处：《中华肝胆外科杂志》2002年第12期745-748,共4页Chinese Journal of Hepatobiliary Surgery

摘　　要：目的　为解决门静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静脉血泵 ,对丝线栓塞性门静脉高压模型犬进行门静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　对杂种犬进行门静脉左右支丝线栓塞术制备门静脉高压动物模型 ;应用高弹力硅胶球囊连接单流向硅胶瓣“T”型管 ,制作搏动性门静脉血泵 ;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”管安置于门静脉主干前壁侧支平面以上 ,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静脉压力在泵工作后由 30 3± 4 2cmH2 O升至 49 0± 7 1cmH2 O ;入肝血流量由 2 70± 2 8ml/min升至 396± 2 5ml/min ;血泵平面以下门静脉压由 31 4± 3 1cmH2 O降至18 0± 4 3cmH2 O ;脾静脉压由 36 2± 4 0cmH2 O降至 2 0 5± 3 4cmH2 O ;胃底静脉压由 35 3± 3 3cmH2 O降至 19 3± 4 7cmH2 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　搏动性门静脉血泵对增加门静脉入肝血流 ,改善肝代谢功能状态及降低侧支压力具有显著作用。Objective To seek an effective method to solve the problem of decreased portal inflow, decreased metabolic function and dangerous varicosis in portal hypertension. Methods A pulsation-type portal pump was prepared and used in a model of portal hypertension established in canine. Two threads were injected into the two branches of the portal vein to inflict portal hypertension. A pulsation-type portal pump was constructed with a silica rubber balloon and a T-shaped silica rubber tube that has two valves at the tips to allow the blood flow in one direction. The pulsation of the balloon was caused by a pair of plates. The plate made of stainless steel was fixed on one side of the balloon while the other made of a strong magnetic steel was fixed on the opposite side. The power was supplied by a low frequency alternating magnetic field that is also placed outside the abdomen. The T-shaped tip of the pump was then placed into the portal vein at the point above the major collateral branches. The blood pressure and flow of the portal system were observed and the liver metabolic functions determined. Results After operation of the pump, the blood pressure above the pump increased from 30.3±4.2 cmH 2O to 49.0±7.1 cmH 2O whereas the pressure below decreased from 31.4±3.1 cmH 2O to 18.0±4.3 cmH 2O, and the blood inflow of the liver increased from 270±28 ml/min to 396±25 ml/min. The pressure of the splenic vein decreased from 36.2±4.0 cmH 2O to 20.5±3.4 cmH 2O and that of the gastric vein decreased from 35.3±3.3 cmH 2O to 19.3±4.7 cmH 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. Conclusions The pulsation-type pump significantly increases the blood inflow and metabolic functions of the liver and decreases the blood pressure of the portal system. The design of the structure and power supply is perfect. Further study should be conducted on long-term in vivo maintenance of the pump.

关 键 词：搏动性门静脉血泵 治疗 实验研究 作用机制 门静脉高压症 

分 类 号：R657.34[医药卫生—外科学]