局部药物注射部分性脾切除的实验研究

Experimental Study of Partial Splenectomy with Local Drug Injection

正常成年家兔１２只分成Ａ、Ｂ两组，剖腹直接穿刺脾脏注入无水乙醇（Ａ组，中部０．３ｍｌ，下极０．２ｍｌ）及鱼肝油酸钠注射液（Ｂ组，中部０．３ｍｌ，下极０．１５ｍｌ）。观察了注射完毕后脾脏坏死灶大小，１０ｄ及２０ｄ后与周围脏器的反应情况，病理学改变。结果显示Ａ组坏死灶为０．５５±０．１５（ｃｍ￣２），Ｂ组为１．４９±０．１５（ｃｍ￣２），Ｂ组坏死灶明显大于Ａ组（Ｐ＜０．０１），１０ｄ与２０ｄ后改变大致相同，主要为大网膜包裹粘连，病理学改变主要为脾窦充血扩张，脾呈片状凝固坏死，周围均有不同程度异物肉芽肿反应、纤维化及炎性细胞浸润，并讨论了无水乙醇及鱼肝油酸钠引起脾坏死原因及产生坏死灶大小差别的依据，证实局部药物注射内科性脾切除是一种安全、可靠、简单的方法，值得推广，并为过渡到临床应用打下基础。

A new modality of partial splenectomy was established by means of local drug injection in rabbits.Group A(n=6) was injected with ethanol 0.3 ml and 0.2 ml in two points,respectively and group B(n=6)with natriimorrhuatis 0.3 ml and 0.2 ml by directly puncturing into spleen through laparotomy.10 and 20 days after operation,the rabbits were sacrificed. The necrostic areas of spleen were determined in both groups.The diameter of necrostic areas of group B(14.9±1.5 mm)was significantly larger than that of group A(5.5±1.5mm),P<0.001.The histopathological findings were analogous in both groups,including coagulative necrosis,fibrosis,granulomatous reaction and inflammatory infiltration surrounding the necrostic areas.It is suggested that this technique can be used to human body under US guiding as an alternative of partial splenic embolization for hypersplenism.