缝扎肝右静脉后肝动脉与门静脉血流改变的实验研究

The change of hemodynamics of hepatic artery and portal vein after the ligated right hepatic vein of pigs

目的 :探讨结扎主肝静脉对肝动脉与门静脉血流动力学的影响。方法 :小型猪共 12头 ,剖腹后 ,电磁血流计测量结扎前后肝动脉、门静脉血流 ,大网膜静脉置管测量结扎前及结扎后 30min、1、3、5、7、14、2 1、2 8、5 6d的自由门静脉压力 (FPP) ,5 6d后再次开腹测量肝动脉、门静脉血流。结果 :FPP术后均升高 ,以术后 7d内明显 ,6头超过 35cmH2 O ,且其中 3头小猪出现上消化道出血 ;肝动脉血流速早期增加 ,5 6d降至略高于术前水平 ;门静脉血流速早期减少 ,未检测到逆向血流 ,术后 5 6d ,门静脉血流速恢复为略低于术前水平。结论 :结扎一条主肝静脉不会引起结扎肝叶的萎缩坏死 ,可能会导致上消化道出血。

Objective:To investigate the hemodynamics of hepatic artery and portal vein after ligated the right hepatic vein of Parma pig.Methods:There were 12 Parma pigs who had bellies open,and blood flows of hepatic arteries and portal veins were measured with electromagnetic flowmeter before and after the right hepatic veins were ligated.Free portal pressure(FPP)was measured through the vein of omentum before and 30min,1,3,5,7,14,21,28,56days after operation.The blood flows of hepatic artery and portal vein were measured again 56 days later.Results:FPP of all pigs increased,and 3 pigs got hemorrhage of upper digestive tract.The flow rate of hepatic artery increased early and decreased later,and constantly faster than that before operation.It was adverse with that of porta vein,and backward flow was never detected.Conclusion:Hemorrhage of upper digestive tract is possible,and atrophy or necrosis of liver is rare when one of the hepatic veins is ligated permanently.