胆道梗阻伴肝动脉血流阻断对肝脏损伤的实验研究

Experimental Studies on Hepatic Impairment After Ligation of Bile Duct and Hepatic Artery

通过检测正常大鼠肝细胞线粒体呼吸功能、ＡＴＰ含量和组织学改变，分别观察肝动脉结扎、胆道梗阻和胆道梗阻伴肝动脉结扎术后肝脏的损伤。结果表明：仅胆道梗阻伴肝动脉结扎组有８３．３３％的大鼠肝细胞出现凝固性坏死。其发生机制是胆道梗阻后门静脉血流量减少，肝脏更加依赖肝动脉血供；另外，肝细胞线粒体呼吸功能抑制和能量代谢紊乱也是肝动脉结扎促成或加重胆道梗阻肝细胞坏死的重要因素。提示对有明显胆道梗阻的病人，行肝动脉结扎或栓塞术应特别慎重。

The present study was carried out to investigate hepatic impairment after ligation of the hepatic artery of rats in the presence and absence of biliary obstruction.The respiratory function of mitochondria in hepatic cells.ATP content and histological changes were examined.The results showed hepatic necrosis in 83.33% of rats subjected to duble ligation and sectioning of the hepatic arteryand common bile duct.The pathophysiologic mechanism is that when portal venous inflow decreased after biliary obstruction,the liver becomes critically dependent upon an intact arterial flow;respiratory impairment of mitochondria and disturbance of energy metabolism of hepatocytes also play an important role in leading to hepatic necrosis.This exberiment proves that interruption of hepatic arterial biood flow by embolism or ligation in the presence of biliary obstruction may increase the risk of hepatic necrosis.So it is suggested that great attention should paid to ligation of embolization of hepatic artery in patients with biliary obstruction.