肝动脉阻断脾动静脉吻合对肝脏功能保护作用的研究

Protective effects of splenic artery-vein anastomosis after hepatic artery ligation on live function

目的 观察肝动脉阻断后脾动静脉吻合的有效性和可行性。方法 将成年杂种犬分为肝动脉阻断组 (HAL组 ) ,肝动脉门静脉吻合组 (PPA1组 ) ,脾动静脉吻合组 (PPA2组 ) ,每组 9只 ,观察术前、术后 1h及 4周时各项指标的变化。结果 HAL组术后门静脉压下降 ,肝静脉PO2 下降、PCO2 上升 ,门静脉GOT及GPT明显升高 ;PPA1,PPA2组术后门静脉压上升 ,PO2 及PCO2 无明显变化 ,GOT及GPT术后 1h明显升高 ,4周时恢复正常 ;PPA1,PPA2组与HAL组指标比较有极显著性差异 (P <0 0 1) ,而PPA1组与PPA2组之间无明显差异 (P >0 1)。结论 脾动静脉吻合与肝动脉门静脉吻合等其它门静脉部分动脉化法一样对肝脏功能具有显著的保护作用 ,为普外科提供了一种手术方法。

ObjectiveTo investigate the efficacy and feasibility of splenic artery-vein anastomosis after hepatic artery ligation. MethodsA total of 27 adult dogs were divided into 3 groups with 9 in each. Hepatic artery ligation was conducted in HAL group, hepatic artery portal anastomosis in PPA1 group and splenic artery-vein anastomosis in PPA2 group. Portal venous pressure, hepatic venous PO_2 and PCO_2, portal venous GOT and GPT were detected before, 1 h and 4 weeks after the operation. ResultsAfter the operation, portal venous pressure decreased in HAL group but increased in PPA1 group and PPA2 group. Hepatic venous PO_2 decreased and PCO_2 increased in HAL group postoperatively. No significant changes of hepatic venous PO_2 and PCO_2 were seen in PPA1 group and PPA2 group. Postoperatively, GOT and GPT markedly increased in HAL group, and increased in 1 h but returned to normal 4 weeks later in PPA1 group and PPA2 group. There was significant difference between HAL group and the two PPA groups (P<0.01). ConclusionsSplenic artery-vein anastomosis, like other methods of partial portal arterialization, can protect hepatic function. Meanwhile, it provides a new method for general surgery.