中华医学杂志
中華醫學雜誌
중화의학잡지
National Medical Journal of China
2008年
14期
998-1001
,共4页
胆汁淤积%胆红素%胆管%肝切除
膽汁淤積%膽紅素%膽管%肝切除
담즙어적%담홍소%담관%간절제
Cholestasis%Bilirubin%Biliary tract%Hepatectomy
目的 探讨阻塞性黄疸程度、时间对大鼠肝叶切除体积的影响.方法 120只Wistar大鼠结扎胆总管致阻塞性黄疸,分为8组,于胆总管结扎后第1、3、5、7天分别行30%、70%肝叶切除+胆肠内引流术,比较各组术后肝功能、肝组织丙氨酸转氨酶及Na+K+-ATP酶含量、病理改变、生存率,了解阻塞性黄疸程度、时间对不同体积肝切除的影响.结果 结扎胆总管术后第3天,血清胆红素水平达高峰,1～8组术后生存率分别为20%、20%、100%、50%、30%、20%、0、0.结扎胆总管术后第1天行30%、70%肝叶切除+胆肠内引流术,高死亡率非肝功能损害造成,而是在短时间难以耐受两次手术.结论 行30%肝叶切除+胆肠内引术是安全的;70%肝叶切除+胆肠内引术风险极大.结扎胆总管术后第5、7天,难以耐受30%以上肝叶切除.
目的 探討阻塞性黃疸程度、時間對大鼠肝葉切除體積的影響.方法 120隻Wistar大鼠結扎膽總管緻阻塞性黃疸,分為8組,于膽總管結扎後第1、3、5、7天分彆行30%、70%肝葉切除+膽腸內引流術,比較各組術後肝功能、肝組織丙氨痠轉氨酶及Na+K+-ATP酶含量、病理改變、生存率,瞭解阻塞性黃疸程度、時間對不同體積肝切除的影響.結果 結扎膽總管術後第3天,血清膽紅素水平達高峰,1～8組術後生存率分彆為20%、20%、100%、50%、30%、20%、0、0.結扎膽總管術後第1天行30%、70%肝葉切除+膽腸內引流術,高死亡率非肝功能損害造成,而是在短時間難以耐受兩次手術.結論 行30%肝葉切除+膽腸內引術是安全的;70%肝葉切除+膽腸內引術風險極大.結扎膽總管術後第5、7天,難以耐受30%以上肝葉切除.
목적 탐토조새성황달정도、시간대대서간협절제체적적영향.방법 120지Wistar대서결찰담총관치조새성황달,분위8조,우담총관결찰후제1、3、5、7천분별행30%、70%간협절제+담장내인류술,비교각조술후간공능、간조직병안산전안매급Na+K+-ATP매함량、병리개변、생존솔,료해조새성황달정도、시간대불동체적간절제적영향.결과 결찰담총관술후제3천,혈청담홍소수평체고봉,1～8조술후생존솔분별위20%、20%、100%、50%、30%、20%、0、0.결찰담총관술후제1천행30%、70%간협절제+담장내인류술,고사망솔비간공능손해조성,이시재단시간난이내수량차수술.결론 행30%간협절제+담장내인술시안전적;70%간협절제+담장내인술풍험겁대.결찰담총관술후제5、7천,난이내수30%이상간협절제.
Objective To investigate the impact of obstructive jaundice on hepatectomy. Methods 120 Wistar rats underwent ligation of the common bile duct to establish animal model of obstructive iaundice. On days 1 after ligation 20 rats underwent 30% hepatic resection+choledochojejunostomy(Group 1)and 20 rats underwent 70% hepatic resection+choledochojejunostomy(Group 2);on day 3 after ligation 10 rats underwent 30% hepatic resection+choledochojejunostomy(Group 3)and 10 rats underwent 70% hepatic resection+choledochojejunostomy(Group 4);on day 5 20 rats underwent 30% hepatic resection+choledochojejunostomy(Group 5)and 20 rats underwent 70% hepatic resection+choledochojejunostomy (Group 6);and on day 7 10 rats underwent 30% hepatic resection+choledochojejunostomy(Group 7)and 10 rats underwent 70% hepatic resection+choledochojejunostomy(Group 8). The serum total protein, albumin, total bilirubin(TBIL), direct bilirubin, and alanine transaminase(ALT)were detected. Then livers were taken out after the rats died or were killed, and the levels of ALT and Na+K6 -ATPase were measure. Results The serum TBIL peaked on day 3. The survival rate after the operation of Groups 1, 2, 3, 4, 5, 6, 7, and 8 were 20%, 20%, 100%, 50%, 30%, 20%, 0, and 0 respectively. Conclusion (1)It is the too short a time between two operations, but not liver dysfunction, that is responsible for the high death rate in Groups 1 and 2. (2)30% hepatic resection+choledochojejunostomy performed 3 days after the ligation of common bile duct iS safe with a survival rate of 100%. However, 70% hepatic resection +choledochojejunostomy is dangerous in this time with a survival rate of 50% only. (3)30% and 70% hepatic resection+choledochojejunostomy performed 5 and 7 days after the ligation are very dangerous with a post-operational survival rate of zero.
