实验性猪原位肝移植术中内毒素血症的观测及血液灌流治疗

Blood perfusion for the treatment of endotoxemia in a swine orthotopic liver transplantation model

目的 观察猪原位肝移植 (OLT)术中内毒素血症的发生和探讨治疗方法。方法 施行猪OLT手术 12例 ,采用无肝期血液灌流治疗内毒素血症。结果 对照组无肝期内毒素水平 x =0 13EU/ml,恢复灌注后 x =0 48EU/ml,活性炭灌流治疗组无肝期内毒素水平 x =0 18EU/ml,恢复灌注后 x =0 13EU/ml(P <0 0 1)。术后 2 4h对照组ALT x =114IU/L ,LDH =1716IU/L ,灌流组ALT x =6 2IU/L ,LDH =10 91IU/L ,均呈现改善 (P <0 0 1)。结论 进行无肝期血液灌流治疗 ,可明显降低血中内毒素水平 。

Objective To observe the development of endotoxemia and its treatment during swine orthotopic liver transplantation (OLT). Methods Blood perfusion was carried out in 12 swine OLT cases during anhepatic period. Results It was 0 18 EU/ml in anhepatic period and 0 48 EU/ml in reperfusion period in control group compared to 0 13 EU/ml and 0 13 EU/ml,respectively in activated charcoal perfusion group( P <0 01).The value of ALT and LDH was 114 IU/L and 1*!716 IU/L,24 h post op in control group compared to 62 IU/L and 1*!091 IU/L,respectively( P <0 01).Conclusion Intraopervative elevated exdotoxin level and resulted hepatic disfunction could be ameliorated by blood perfusion using activated charcoal.