CAJ | 학술논문

目的探讨保留肝动脉入肝血流阻断法对硬化肝脏缺血再灌注损伤的预防保护作用.方法四氯化碳大鼠肝硬化模型及正常大鼠根据血流阻断方式分为4组:正常对照(N-SO)组；硬化对照(C-SO)组；Pringle阻断(PTC)组；保留肝动脉血供入肝血流阻断(PVC)组.于阻断期比较各组肝切除术中肝断面出血量.复流后1h、6h及24 h取标本,检测血清丙氨酸转氨酶(ALT)、肝组织三磷酸腺苷(ATP)及丙二醛(MDA)含量,制作组织病理切片行形态学观察.结果肝断面出血量PTC组＜PVC组＜N-SO组＜C-SO组(P＜0.05).复流1h、6h及24 h,血清ALT值及肝组织MDA值检测PTC组＞PVC组＞C-SO组＞N-SO组(P＜0.05)；肝组织ATP值PTC组＜PVC组＜C-SO组＜N-SO组(P＜0.05)；肝脏形态学观察,PTC组及PVC组病理改变重于C-SO组,PTC组损伤程度更重.结论保留肝动脉血供入肝血流阻断法可有效控制肝硬化大鼠肝断面出血,并显著减轻肝脏缺血再灌注损伤.
목적 탐토보류간동맥입간혈류조단법대경화간장결혈재관주손상적예방보호작용.방법 사록화탄대서간경화모형급정상대서근거혈류조단방식분위4조:정상대조(N-SO)조；경화대조(C-SO)조；Pringle조단(PTC)조；보류간동맥혈공입간혈류조단(PVC)조.우조단기비교각조간절제술중간단면출혈량.복류후1h、6h급24 h취표본,검측혈청병안산전안매(ALT)、간조직삼린산선감(ATP)급병이철(MDA)함량,제작조직병리절편행형태학관찰.결과 간단면출혈량PTC조＜PVC조＜N-SO조＜C-SO조(P＜0.05).복류1h、6h급24 h,혈청ALT치급간조직MDA치검측PTC조＞PVC조＞C-SO조＞N-SO조(P＜0.05)；간조직ATP치PTC조＜PVC조＜C-SO조＜N-SO조(P＜0.05)；간장형태학관찰,PTC조급PVC조병리개변중우C-SO조,PTC조손상정도경중.결론 보류간동맥혈공입간혈류조단법가유효공제간경화대서간단면출혈,병현저감경간장결혈재관주손상.
Objective In order to improve cirrhotic liver management,each aspect of the liver's complex blood flow must be understood.This study investigates the protective effect of portal vein occlusion,with hepatic artery preservation,on cirrhotic liver after ischemia and reperfusion.Methods Carbon tetrachlorideand induced cirrhotic rats and normal rats were randomly assigned into 4 groups:normal sham operation (N-SO),cirrotic sham operation (C-SO),portal triad clamping (PTC),and portal vein clamping without hepatic artery inflow control (PVC).During the occlusion,the total 3-minute blood loss from the liver surface cut was weighed.At 1,6,and 24 hours post reperfusion,the serum alapine amino transferas (ALT),the adenosine triphosphate (ATP) of liver tissue,the malonolialdehgde (MDA) of liver tissue,and the morphological changes were evaluated.Result The amount of hemorrhage between the groups ranked as follows:PTC ＜ PVC ＜ N-SO ＜ C-SO (P＜0.05).At 1,6,and 24 hours post reperfusion.the ALT and MDA levels of the groups ranked as follows:PTC ＞ PVC ＞ C-SO ＞ N-SO (P＜0.05).Additionally,each group's ATP level ranked as follows:PTC ＜ PVC ＜ C-SO ＜ N-SO (P＜0.05).With histopathological examination,the hepatic injuries of the PTC and PVC group were more severe than those of the C-SO group,especially in the PTC group.Conclusion Therefore,the technique of portal vein clamping and hepatic artery inflow control can reduce the ischemic reperfusion injury of the cirrhotic rats' liver.