高原地区常温下肝门血流阻断对肝脏耐缺血安全时限的实验研究

EFFECT OF NORMTHERMIC BLOCKADE OF HEPATIC PORTAL BLOOD FLOW FOR SAFETY TIME LIMIT OF HEPATIC TOLERANCE TO ISCHEMIC AT HIGH ALTITUDE

肝癌的治疗目前仍以瘤块切除为主，但术中出血为常见并发症，常温下一次阻断入肝血流的安全时限为１５～２０分钟￣［１、２］，高原地区低氧环境下（氧分压１６．２ｋＰａ）一次性入肝血流阻断安全时限仍有一些争论，本文选用海拔２７００ｍ以上地区１３只健康狗的实验研究，结果Ａ、Ｂ两组为安全时限；Ｃ、Ｄ两组狗死亡率较高，生理变化较大，光镜和电镜报告肝细胞有明显损害。在平原地区临床报道在常温下一次性阻断肝血流达６５分钟而术后存活良好￣［４］。本实验在高原地区肝门阻断血流以２０分钟为安全时限，生理变化不大，肝细胞损害不明显，这个研究结果对高原地区肝叶切除一次性入肝血流的阻断提供了可靠的依据。

AbstractAt present the main treatment to the liver canceris still tumors resection,but blooding is thecommon complication during the operation. The safety time limit of normothermic blooding ofblood flow entered liver is 15-20 minutes. However there are some dispute about it in hypoxia cir-cumstance(Po=16. 2Kp)at hight altitude. In this experiment we choosed 13 healthy dogs whichlive in the altitude above 2 700m to test,It is result that group A and group B,both are in safetytime limit.The mortality of group C and group D is higher. Group C and Group D on physiologicalchanges are dramatic and it is showed that liver cell were obviously damaged by optical microscopic and electron microscopic,It was clinical report on lowland that safety time limit of normothermic hepatic vascular exclusion up to 65 minutes but after surgery survikal is better.Thisstudy show that at high altitude area it is 20 minutes. Physiological changes of the liver is lit-tle.The damage for liver cell isn’t distinct.This result provided reliable basis for the blockade ofblood flow entered liver during liver lobectomy at high altitude area. Key wards liver lobectomy;blockade of hepatic portal blood flow;safty time limit