区域动脉灌注治疗重症急性胰腺炎实验研究

EXPERIMENT STUDIES OF CONTINUOUS REGIONAL ARTERIAL PERFUSION

目的 寻求治疗重症急性胰腺炎的有效途径。方法 复制大鼠重症急性胰腺炎 (SAP)模型 ,随机分组后经股动脉插管至腹腔动脉开口处 ,分别给予善得定、改善微循环药物及两种药物联合持续动脉灌注 ,观察胰腺、肝脏病理改变及血淀粉酶、肝功能的变化。结果 模型建立 6h后 (对照组 )血清淀粉酶、肝功能有指标明显升 ,胰腺水肿、渗出并有大片出血、坏死 ,肝脏淤血肿胀。各治疗组都有不同程度的治疗作用 ,其中联合用药组疗效最佳。结论 区域动脉灌注是治疗SAP的有效方法 ,对防止肝功能障碍有重要作用 ,是进一步提高疗效的有效途径。

Objective To investigate the more rational ways of treatment of severe acute pancreatitis (SAP).Methods SAP model was found by retrograde injection of 5% Sodium taurocholate(1.0 ml) in the subserosa of pancreas,in rats(n=80)weighting 200～250 g.The rats were catheterized using PE-50 angiocatheter from femoral artery to celiac trunk.then they were randomly divided into four groups.20 animals served as controls(A group)and received only fluid resuscitation infusion(0.9% NS,4.0 ml/3 h).The 40 animals,B and C groups 20(animals in each one group)received continuous regional arterial infusion(CRAI) somatostatin (4 ug/kg),the medicines of improving microcirculatory (Dextran-40 1.5 ml,Dopamine Hydrochloride 5ug/kg,Anisodaminum 1.5 ml/kg)respectively,the 20 animals (D group) were treated by allied somatostatin and the medicine of improving microcirculatoy through CRAI simultaneously with the induction of pancreatitis(4.0 ml/3 h).The serum Amylase、AST、ALT、ALP were recorded,The liver and pancreas tissue were observed by pathology after 6 hour.Results There were a significant decrease in the serum amylase in B group(P<0.05) and D group(P<0.05)。AST、ALT、ALP were decreased in C and D groups.The harm of liver and pancreas were reduced in B、C and D group.Conclusion CRAI was effective in preventing liver from damage duo to SAP.and it was an effective way to treat SAP.