胆管减压在急性重症胆管炎治疗中的作用

The Role of Decompression of Biliary Ducts in Treatment of Acute Cholangitis of Severe Type

目的 :观察胆管减压对急性重症胆管炎大鼠的影响。方法 :制造急性重症胆管炎和胆管减压内引流大鼠模型。通过测定外周血内毒素含量、总胆红素浓度、补体水平、T -淋巴细胞亚群变化和肝细胞活力 ,观察胆管减压在急性重症胆管炎治疗中的作用。结果 :急性重症胆管炎大鼠外周血中内毒素含量、总胆红素浓度均明显升高 ,肝细胞活力明显下降 ,细胞免疫功能降低 ,表现为 :CD3 百分率升高 ,CD4/CD8比值下降 ,补体系统激活 ,C3 、C4水平升高。胆管减压内引流后 ,总胆红素浓度下降 ,肝细胞活力增强 ,CD3 百分率下降 ,CD4/CD8比值升高。但外周血内毒素含量没有明显变化 ,补体仍维持在较高水平。结论 :及时有效的胆管减压内引流是治疗急性重症胆管炎成功的关键之一 。

Objective:To observe the influence of decompression of biliary ducts on the rats with severe acute cholangitis.Methods: The models of rats with severe acute cholangitis and inner drainage of decompression of biliary ducts were (made.)The role of decompression of biliary ducts in treatment of severe acute cholangitis was observed by means of measuring the endotoxin content in peripheral blood,the level of total bilirubin and complement,the change of subgroup of T-lymphocytes and activity of hepatic cells.Results:In the peripheral blood of rats with severe acute cholangitis,the level of edotoxin and total bilirubin was elevated remarkbly,the activity of hepatic cells was reduced ,and cellular immunity was lowered.The manifestations were that the percentage of CD_2 rose,the ratio of CD_4/CD_8 declined, the complement system was activated,and the levels of C_3 and C_4 were elevated.After inner drainage of decompression of biliary ducts,the level of hepatic cells was reinforced,percentage of CD_3 was lowered, and the ratio of CD_4/CD_8 rose.However,there was no obvious change of endotoxin content in peripheral blood,and complement remained on a relalively high level.Conclusions: Immediate and effective inner drainage of decompression of biliary ducts is the key to the curing severe acute cholangitis, and in addition it may prepare the ground for other therays of the disease.