兔肝脏储备功能的实验研究

EXPERIMENTAL STUDY OF HEPATIC FUNCTIONAL RESERVATION

对４０只健康新西兰种大白兔，连续腹腔注射硫代乙酰胺６５天，建立慢性肝损伤动物模型，然后按不同比例行肝部分切除术。采用手术前后自身对照和组间相互对照方法，测定手术前后吲哚氰氯１５分钟血中潴留率（ＩＣＧＲ１５ｍｉｎ）、过氧化脂质（ＬＰＯ）及常规肝脏功能检查，并进行统计分析。结果表明：在慢性肝损伤状态下，肝功能的改变与手术结果密切相关，当ＩＣＧＲ１５ｍｉｎ＞４０％或血清白蛋白＜２．８ｇ％时，术后死亡率高达５０％以上；肝功能计分法对手术结果的预测准确率为８８．９％；肝切除量也与手术预后密切相关，当肝切除量＞４０％时，术后死亡率在４４．４％以上；ＬＰＯ含量与慢性肝损伤的程度呈正相关关系。

The experimental models of chronic hepatic lesion of 40 rabbits were made by intra-abdominal injection of thioacetamide.The chronic hepatic lesion was confirmed by pathological examination and hepatectomies were performed in accordance with different measurements on each rabbit. The observations included indocyanine green retention rate, hepatic resection volume,and the outcomes of operations.The results showed that the mortality was correlative with the change of hepatic functions in the background of chronic hepatic lesion.The indocyanine green retention and the level of serum albumin are important parameters to indicate hepatic impairment.When the former was over 40% or the latter below 2.89% the operative danger was high and the mortality was over 50%.In accordance with the classification of hepatic function,the preoperative functional state of liver were classified:grade A,B and C,the mortality of posthepatectomy were respectively 16.7%,30 %,and 72%. The multiple progressive regression equation is employed for calculating the postoperative outcome.The equation predicted the postoperative outcome with 88.9% accuracy.