摘要
目的 :研究碘油/无水乙醇肝节段性栓塞术后肝脏的病理变化过程 ,及此过程中肝、肾功能的改变 ,为临床推广应用提供依据。材料和方法 :以健康杂种犬为实验对象(n=12) ,碘油/无水乙醇(Lp/E ,比例4∶1)作为栓塞剂 ,行肝节段性栓塞 ,术前、术后监测血常规、淀粉酶、肝肾功能 ,术后定期复查肝动脉造影、CT并分批处死实验犬进行肝肺组织学检查。结果 :术后定期复查肝动脉造影示靶肝动脉均明确闭塞。病理检查发现肝栓塞区小动脉血栓形成 ,1周后血栓机化 ,术后4周栓塞肝组织完全坏死 ,坏死肝细胞完全崩解 ,代之以纤维组织增生。术后1天白细胞出现一过性升高 ,术后1周即恢复术前水平。肝功能呈一过性损害 ,术后1～3周恢复术前水平 ,主要表现为ALT、AST、γ -GT、ALP和TBA的升高。结论 :Lp/E具有确实的栓塞效果 ,能达到“内科性肝段切除”的目的。
Purpose:To study the histological changes in liver after being segmentally embolized with lipiodol/absolute-ethanol.Materials and Method:Twelve dogs were segmentally embolized with lipiodol/ethanol (Lp/E,with the ratio at 4∶1).Periodical reexaminations with CT and hepatic arteriography were performed after the precedure.Simultaneous blood routine,liver and kidney function tests were monitored before and after the embolization.1,7,14,28 days after embolization,the dogs were killed in batches for histological examinations on liver and lung.Results:All dogs were kept alive till being killed.Periodical reexaminations with hepatic arteriography revealed that target hepatic arteries were all definitely occluded.Pathological examination revealed arteriolar thrombosis in the embolized regions of liver.Organization of thrombus happened after 1 week.The embolized regions became totally necrotized after 4 weeks.Necrotic hepatic cells completely disintegrated and were repleaced by hyperplastic fibrus tissue.Leucocytes increased transiently 1 day after embolizatin and dropped to the pre-embolization level within 1 week.Liver function was temporarily damaged as shown by increased levels of ALT,AST,γ-GT?ALP and TBA,however recovered 1 to 3 weeks later.Conclusion:Lp/E does have embolizing effect and can achieve the ABSTRACT Purpose of medical hepatic segmentectomy.
出处
《中国医学计算机成像杂志》
CSCD
2001年第5期342-345,共4页
Chinese Computed Medical Imaging
