大鼠梗阻性黄疸及其肝切除时入肝血流阻断时限研究

Ischemic tolerance of obstructive jaundice liver and hepatectomy in rats with portal trial clamping

目的探讨在门静脉未转流下梗阻性黄疸及其肝切除时第一肝门阻断耐受时限。方法胆总管结扎3d后72只大鼠,随机分6组行手术,检测各组术后血清转氨酶、肝组织匀浆中黄嘌呤氧化酶含量、肝组织病理学变化、肝细胞增殖细胞核抗原表达,术后1周内各组动物生存只数。结果胆道梗阻3d大鼠第一肝门阻断15min以内,术后1周全部存活;肝叶切除时第一肝门阻断15min,术后1周多数死亡。结论梗阻性黄疸大鼠在门静脉未转流下常温入肝血流阻断(PTC)时限应<15min,如行肝叶切除,PTC时限应<10min。

Objective To investigate the maximun tolerance of obstructive jaundice liver in rats undergoing hepatectomy with portal trial clamping （PTC） and without portal blood bypass. Methods Three days later, 72 wistar rats that underwent biliary obstructive operation were randomly divided into six groups according to the hepatocholangioenterostomy and the duration of PTC time. Indicators of liver functions including transaminase （ ALT）, XOD and PCNA were tested during the 1st, 4th and 7th days after the operation respectively. When operation was finished, 10% liver parenchyma was taken and preserved in formalin and liquid nitrogen to test the expression of PCNA and the content of XOD. In each group, the survival time was counted within 1 week. Results All rats with portal trial clamping within 15min survived 7 days after occiusion, most of rats with hepatic resection and portal trial clamping for 15 min died 7 days after occiusion. Conclusion For the obstruction jaundice rats without portal blood bypass, the safe time of PTC under normal temperature should be 15 min,and the safe time of PTC with hepatic resection should be 10 min.