肝脏革氏鞘内管道三级分支结扎后相应区域循环代偿机理的研究

STUDY ON MECHANISM AND ABILITY OF BLOOD SUPPLY COMPENSATION IN THE INVOLVED AREA OF LIVER FOLLOWING LIGATION OF THE THIRD GRADE BRANCHES OF DUCTS ENCLOSED IN THE GLISSON’S CAPSULE

目的 了解肝内局部的循环代偿能力及其机理。方法 利用电镜观察肝脏微血管变化 ,经血管造影、肝脏ECT检查和血管铸型等了解局部肝脏血管结构及血液循环的变化。结果 在结扎相应血流管道 3 0 60分钟后 ,即有缓慢血供通过肝窦间吻合进入受累区域 ,并使血流管道保持通畅。 6周后 ,受累区域局部血供丰富 ,有较多肝动脉侧支血管及新生毛细血管供血。结论 肝脏对局部的缺血有较强的代偿能力。

Objective To observe the blood circulation compensation in the involved area of the liver following ligation of the third grade branches of hepatic artery and portal vein and bile duct enclosed in Glisson’s capsule. Methods Ligation of the third grade branches of these ducts was carried out in 7 pigs. Uptake of 99mTc-EHIDA in the liver was scanned with SPECT pre- and post-operatively. Liver angiography of hepatic artery and portal vein were taken at regular interval. Corrosion casts of these ducts were made with ABS following extirpation of the liver at the end of experiment. The histological specimens were examined with electronic microscope. Results Compensatory circulation occurred between involved and noninvolved part of the liver through the sinusoids in 30-60 minutes after ligation. In the 6 weeks following the procedure, there was also blood supply in the affected region of liver, and collateral developed through hepatic aterioles and capillaries. Conclusion Liver has an ability to establish compensatory blood supply on the condition of ischema in a local region of liver.