分流与断流对肝硬变门脉高压大鼠胃粘膜的影响

Effects of Shunt and Devascularization on Gastric Mucosa of Cirrhotic Rats with Portal Hypertension

为探讨分流与断流对门脉高压时胃粘膜的影响，本实验采用ＣＣＬ４皮下注射诱导制作肝硬变门脉高压大鼠模型，模仿临床方法施行肠腔分流与联合断流术，以假手术作对照同步观察两类手术对肝硬变门脉高压大鼠胃粘膜多项功能与形态学指标的影响。结果显示：两类手术在实验观测时期内均有显著降低门静脉压作用，降压幅度以分流术为大；同对照组相比，分流组胃粘膜血流量、胃粘膜电位差显著增加，胃粘膜下层厚度、血管相对横截面积及胃粘膜病变指数明显降低，提示分流术后胃粘膜血运循环得到改善，胃粘膜屏障功能得以恢复，胃粘膜充血水肿减轻及胃粘膜病变减轻，而断流组除粘膜下层厚度及血管相对横截面积有轻度降低外，上述其他指标均呈相反结果。

Cirrhotic rats induced by CCl 4 injection were subjected to shunt or devascularization in order to investigate the effects of the two operations on the gastric mucosa with portal hypertension and compared with those of sham operation on controls.The results showed that portal pressure was decreased after either shunt or devascularization being more markedly decreased after shunt. The shunt group had evidently increased gastric mucosal blood flow and potential difference,decreased submucosal thickness and relative vascular area and mucosal pathologic change index.The devascularization group had all contradictory results except for slightly decreased mucosal thickness and relative vascular area.The above results indicate that shunt improved gastric mucosal circulation,resumed the mucosal barrier,abated edema of mucosa and submucosa.On the contrary,devascularization impaired the mucosal circulation,damaged the mucosal barrier and aggravated gastric mucosal pathologic changes.