脾动脉结扎对大鼠肝大部分切除术后细菌移位的影响

Effect of Splenic Artery Ligation on Bacterial Translocation after Major Liver Resection in Rats

目的研究脾动脉结扎对大鼠肝大部分切除术后细菌移位的影响。方法将54只SD大鼠按随机数字表法分为3组:假手术组、三分之二肝切除组、肝切除加脾动脉结扎组,每组18只。54只大鼠中24只用于测定门静脉压力,30只用于分析细菌移位、血浆内毒素。结果三分之二肝切除组门静脉压力(1.31±0.06)kPa显著高于假手术组(0.75±0.04)kPa(P<0.01)和肝切除加脾动脉结扎组(0.98±0.05)kPa(P<0.01)。此外,三分之二肝切除组的细菌移位率高于假手术组(60.0%vs 10.0%,P=0.001),而脾动脉结扎则能显著的减少肝大部分切除术大鼠细菌移位的发生(30.0%vs 10.0%,P=0.011)。三分之二肝切除组血浆内毒素(4.05pg.mL-1)与假手术组(0.00pg.mL-1)、肝切除加脾动脉结扎组(1.75pg.mL-1)相比,大鼠内毒素显著降低,差异有统计学意义(P<0.01)。结论脾动脉结扎能降低大鼠肝大部分切除术后门静脉压力,增强肠黏膜屏障功能,减少内毒素和细菌移位的发生,所以脾动脉结扎可以预防肝大部分切除后感染的发生。

Objective To investigate the effects of splenic artery ligation on bacterial translocation（BT） after major liver resection in rats.MethodsFifty-four rats were divided into three groups： sham operation group,two-thirds partial hepatectomy group and two-thirds partial hepatectomy plus splenic artery ligation group.Portal pressure was measured in 24 rats and BT and endotoxemia were analyzed in 30 rats.ResultsPortal pressure in two-thirds partial hepatectomy group（1.31±0.06）kPa was significantly greater than that in sham operation0 group（0.75±0.04）kPa or two-thirds partial hepatectomy plus splenic artery ligation group（0.98±0.05）kPa（P0.01）.In addition,the rate of BT in two-thirds partial hepatectomy group was higher than that in sham operation group（60.0% vs 10.0%,P=0.001）,and splenic artery ligation significantly reduced BT（30.0% vs 10.0%,P=0.011）.Endotoxemia was not evident in sham operation rats（0.00 pg·mL-1）,but blood endotoxin levels decreased in two-thirds partial hepatectomy plus splenic artery ligation group compared with two-thirds partial hepatectomy group rats（1.75 pg·mL-1 vs 4.05 pg·mL-1,P0.01）.ConclusionSplenic artery ligation can reduce portal pressure,enhance intestinal barrier function and diminish blood endotoxin levels and BT in rats undergoing major liver resection.Therefore,splenic artery ligation may be useful in the prevention of infection after major liver resection.