混合性胆固醇结石体内灌注溶解实验

Perfusive dissolution of mixed cholesterol gallstone in vivo

目的：以动物胆囊模拟人胆囊环境，观察结石在胆囊内的溶解情况，了解溶剂机体毒性及不同灌注途径下对机体的影响。方法：１４例胆石标本各１枚经胆囊造瘘埋入兔胆囊，甲基叔丁醚（ＭＴＢＥ）和实验组（自制复方溶剂组）均分别各３例经胆囊造瘘管和逆行胆囊插管灌注溶剂，生理盐水组２例经胆囊造瘘管灌注。于第１２小时取出残石，烘干，称量，计算胆石溶解率。测定溶石前后血清总胆红素、ＡＬＴ、ＢＵＮ、Ｃｒ行胆囊壁。

Objective: To investigate the dissolution of gallstone in the rabbit gallbladder imitating the situation of human body and to understand the toxity of solvents to the body and the effect of solvents perfused by different ways. Methods: Each gallstone from 14 cases were embeded into rabbit gallbladder, 3/6 cases were perfused with MTBE or the tested solvent through cholecystostomy tube or the retrograde gallbladder catheter respectively, and 2 cases were perfused with saline through cholecystostomy tube. At the 12th hour the gallstone residue was taken out, dried and weighed, and the percentage of dissolution was calculated. Before and after the dissolution, serum ALT,total bilirubin, BUN and Cr were measured. The pathological changes of the wall of gallbladder and duodenum were examined. Results: It took (7.3±1.25) h to resolve 83 33% gallstones completely in the tested solvent group ,superior to that in the MTBE group. The biochemical indications after dissolution were not significantly different from that of the saline group before dissolution. The pathological examination showed that the injury of the gallbladder wall and duodenum wall caused by the tested solvent was slight. Conclusion: The dissolubility of the tested solvent in the gallbladder is high, and its toxity to the body is limited.