门静脉和下腔静脉阻断对猪胃肠氧供需平衡的影响

Effects of clamping the portal vein and retrohepatic vena cava on gastric-intestine oxygen supply- comsumption balance in pigs

目的 观察猪门静脉和下腔静脉阻断对胃肠氧供需平衡的影响。方法 8头实验用家猪 ,在门静脉和下腔静脉阻断前、阻断 5 0min和开放后 6 0min ,分别从动脉和门静脉抽血行血气分析 ,计算肠氧供需的变化 ;在阻断前和手术结束时取回盲部小块肠组织作病理学检查。结果 (1)氧摄取率 (CEO2 )和动脉 门静脉氧含量差 (Ca pvO2 )在阻断后 5 0min最高 (P <0 0 1) ,开放后 6 0min次之 (P <0 0 5 ) ;门静脉血氧含量 (CpvO2 )阻断前最高 ,阻断 5 0min时明显减少 (P <0 0 1) ;(2 )动脉血气分析各时间点无明显差异 ,门静脉血气显示 ,门静脉血氧分压 (PpvO2 )、门静脉血氧饱和度(SpvO2 )、门静脉血 pH值 (pHpv)、门静脉血剩余碱 (BEpv)在阻断时降低 (P <0 0 5或P <0 0 1) ,开放后能基本恢复至阻断前水平 ;(3)病理结果显示阻断后肠粘膜存在损伤。结论 门静脉和下腔静脉阻断后猪胃肠氧供需失衡 ,开放后胃肠氧供需失衡改善。

Objective To observe the effects of clamping portal vein and retrohepatic vena cave on gastric-intestine oxygen supply-consumption balance in pigs.Method Eight pigs were studied.Blood gas analysis was performed with artery blood and portal vein blood samples before clamping the portal vein and retrohepatic vena cava at 50min during clapming and at 60min after the clamp relieving.Gastrointestinal oxygen metabolism data were calculated.Structure of the small intestine tissues in ileum distal end was observed by light microscope before clamping portal vein and retrohepatic vena cava and at 60min after clamp relieving.Results (1)In three time points,CEO 2 and Ca-pvO 2 were the highest at 50min during clamping,CEO 2 and Ca-pvO 2 at 60min after the clamp relieving was higher than those during clamping.CpvO 2 was the highest before clamping and CpvO 2 at 60min after the clamp relieving was higher than that at 50min during clamping.(2)PpvO 2,SpvO 2,pHpv,BEpv decreased at 50min during clamping and recovered to the basic levels after clamp relieving.(3)The pathlogical results showed that gastrointestinal mucosa damage could be seen.Conclusion Gastrointestinal oxygen supply-consumption imbalance occured after the portal vein and retrohepatic vena cava were clamped and 60min after the clamp relieving.