保留半肝动脉血供肝血流安全阻断时限的研究

Research on tolerance limit of rats to hepatic inflow oceulusion with half-hepatic artery supply retained

目的:探讨门静脉自然转流及非转流情况下保留半肝动脉血供肝血流阻断的安全时限。方法:将实验大鼠分为A、B、C组。A组保留肝左、肝中动脉血供及尾状叶动脉、门静脉血供(约占全肝5%),夹闭肝左、肝中叶门静脉,结扎肝右叶肝蒂,到预定阻断时相点,恢复肝脏灌流,切除肝右叶及尾状叶,24 h后检测ALT、肝脏HE染色(细胞核)阳性面积的平均百分数及术后7 d存活率。B组不保留尾状叶动脉、门静脉血供,其他与A组相同。C组完全阻断肝脏入肝血流,肝切除方式及检测指标与A组相同。结果:在A、B、C 3组中,A组的阻断形式对肝脏的损害最轻,B组次之,C组最重。A/100、B/40与C/20损害程度相当。结论:大鼠门静脉转流下保留半肝动脉血供入肝血流阻断的安全时限是100 min,单纯保留半肝动脉血供入肝血流阻断组的安全时限是40 min。

Objective： To study the tolerance limit of rats to hepatic inflow occlusion with half-hepatic artery supply retained and together with portal vein blood bypass or not. Methods： Rats were randomly divided into three groups （group A, B and C）： left and middle hepatic artery supply were remained in both A and B group, caudate lobe supply（Including part of artery and por- tal vein supply of caudate lobe,about 5% in total hepatic blood supply） were together remained in the A group while not remained in the B group; the hepatic inflow were completely blocked in the C group; in both A and B groups, liver perfusion were blocked by clamping the left and the middle branches of portal vein and ligating the hepatic pedicle of the right liver lobe, and then recovered and right liver lobe and caudate liver lobe were cut at the scheduled time; Blood ALT values, HE staining positive rate of liver cells and rats survival rate within 7 days were recorded. Results： Liver damage in the group A is the smallest,then is the group B,and the biggest damage is in the group C; Damage to A/100, B/40 and C/20 is in the same level. Conclusion： 100 min is the tol- erance limit of hepatic inflow occlusion rats with portal vein blood bypass and half-hepatic artery supply retained,while 40 min is the tolerance limit of half-hepatic artery supply retained rats with- out portal vein blood bypass.