离体猪肝机械灌注模型的建立及其在高强度聚焦超声研究中的意义

Establishment of an isolated porcine liver machine perfusion model for high-intensity focused ultrasound studies

目的探讨建立离体猪肝机械灌注模型的可行性及在高强度聚焦超声(HIFU)基础研究中的意义。方法对屠宰场获取的2l例猪肝以双血管(经门静脉和肝动脉)、自体血灌注液、体外循环机离体灌注4 h,监测肝脏的颜色、质地、质量、血流动力学(流量及压力)、彩色多普勒超声影像、胆汁分泌量、组织病理学变化以评价灌注效果。结果 19例猪肝同时经门静脉和肝动脉插管成功,2例肝动脉插管失败。灌注后4 h肝脏质地柔软、血流动力学各参数稳定且保持在相对正常的生理范围内,灌注3 h内胆汁分泌量>3 ml/h,组织病理学显示脏组织总体无形态结构的改变。结论离体猪肝机械灌注模型是稳定、可行的,能满足HIFU基础研究中的实验要求。

Objective To explore the feasibility of establishing an isolated porcine liver machine perfusion model and assess its value in high-intensity focused ultrasound studies. Methods Twenty-one isolated porcine livers were perfused with autologous blood for 4 h through dual vessels （portal vein and hepatic artery） cannulation using an extracorporeal circulation machine under a subnormothermic perfusion condition. The perfusion model was assessed by monitoring the liver color, texture, liver weight gain, hemodynamic parameters, color Doppler flow imaging, bile output and histopathology. Results Nineteen isolated porcine livers were successfully cannulated with dual vessels, and failure of hepatic artery intubation occurred in two porcine livers. After machine perfusion for 4 h, the isolated livers maintained a soft texture with stable hemodynamic levels within relative normal physiological ranges. The bile output was more than 3 ml/h within the initial 3 h of perfusion. Histopathological examination demonstrated no morphological or structural changes of the liver tissues. Conclusion The isolated porcine liver per fusion model is stable and feasible, and can be used for high-intensity focused ultrasound studies.