CAJ | 학술논문

目的研究附加门体分流术对小体积移植肝的保护效果.方法建立巴马小型猪小体积肝移植模型,将15只小型猪平均分为3组:(1)A组,小体积肝移植组(对照组);(2)B组,远端脾肾分流术+小体积肝移植组;(3)C组,肠腔H形分流术+小体积肝移植组.手术后观察动物7 d存活率,动态监测肝功能生化指标、自由门静脉压、门静脉血流量(PBF)以及移植肝组织病理学改变.结果动物7 d存活率分别为:A组1/5,B组3/5,C组5/5.A组动物移植肝复流后自由门静脉压立即升高,高峰达(28.6±2.07)mm Hg(1 mm Hg=0.133 kPa),复流1 h后单位肝组织PBF达(3.56±0.1 1)ml·min-1·g-1;移植肝组织病理学改变严重,包括肝细胞气球样变或肝细胞坏死、肝窦淤血、肝实质出血.B、c组中动物肝功能酶学指标有所改善.移植肝复流后自由门静脉压显著低于A组水平(P<0.05),PBF保持相对平稳.移植肝组织病理学病变明显减轻.结论附加门体分流术可能可以避免小体积移植肝的损伤.
목적 연구부가문체분류술대소체적이식간적보호효과.방법 건립파마소형저소체적간이식모형,장15지소형저평균분위3조:(1)A조,소체적간이식조(대조조);(2)B조,원단비신분류술+소체적간이식조;(3)C조,장강H형분류술+소체적간이식조.수술후관찰동물7 d존활솔,동태감측간공능생화지표、자유문정맥압、문정맥혈류량(PBF)이급이식간조직병이학개변.결과 동물7 d존활솔분별위:A조1/5,B조3/5,C조5/5.A조동물이식간복류후자유문정맥압립즉승고,고봉체(28.6±2.07)mm Hg(1 mm Hg=0.133 kPa),복류1 h후단위간조직PBF체(3.56±0.1 1)ml·min-1·g-1;이식간조직병이학개변엄중,포괄간세포기구양변혹간세포배사、간두어혈、간실질출혈.B、c조중동물간공능매학지표유소개선.이식간복류후자유문정맥압현저저우A조수평(P<0.05),PBF보지상대평은.이식간조직병이학병변명현감경.결론 부가문체분류술가능가이피면소체적이식간적손상.
Objectives To evaluate the protective effects of affiliating portasystemie shunt on small-for-size graft in liver transplantation. Methods Fifteen Chinese Bama miniature pigs were divided into three groups: group A (small-for-size liver transplantation ), group B (distal splenorenal shunt + small-for-size liver transplantation) ,and group C( mesocaval H-shape shunt + small-for-size liver transplantation). Animals were followed up for 7 days with survival, dynamical liver function biochemical parameters, liver biopsies, portal venous pressure (PVP) and portal blood flow (PBF). Results Animal survivals were as follows: group A,1/5,group B,3/5 and group C,5/5. Group A resulted in abnormal liver function parameters that were significantly ameliorated in group B and C. The histological examination of graft in group A displayed severe pathologic changes including hepatocyte cacuolar change or necrosis, sinusoidal congestion, parenchymal hemnrrage. Affiliating portasystemie shunt significandy alleviated graft injuries in group B and C. PVP rose and peaked up to 28. 6 mm Hg( 1 nun Hg =0. 133 kPa) ,PBF fluctuated after reperfusian in group A, but group B and C with affiliating protosystemie shunt showed significandy lower PVP and maintained rather stable PBF after reperfusinn. There were also statistical differences in PVP or PBF between group B and C. Conclusions Affdiating portasystemie shunt effectively might protect small-for-size graft from injuries after reperfusion.