摘要
目的探讨肝移植治疗猪急性肝功能衰竭的近期疗效和手术要点。方法经门静脉注射0.5g/kg D-氨基半乳糖和1μg/kg脂多糖诱导猪急性肝功能衰竭。实验动物随机分为A、B两组。A组(n=6):不接受肝移植治疗;B组(n=5):接受肝移植治疗。观察两组动物的生化指标、病理改变和1周年存率。结果A组注药后48h血清天冬氨酸氨基转移酶、总胆红素、血氨和凝血酶原时间达最高峰,1周年生存率为17%,肝脏病理检查显示大量肝细胞坏死伴出血。B组受体术后第7d天冬氨酸氨基转移酶、总胆红素、血氨和凝血酶原时间水平基本恢复至正常水平,1周生存率为100%,术后第8d获取的移植肝组织常规病疗猪急性肝功能衰竭的近期疗效肯定。手术成功的关键在于术前受体凝血功能障碍的纠正、术中静脉转流的使用以及可靠的血管重建方法。
Objective To investigate the short-trem efficacy and surgical experience of orthotopic liver transplantation for porcine acute hepatic failure. Methods Porcine acute liver failure was induced by intraporta administration of 0.5g/kg D-galactosamine and l#g/kg Lipopolysaccharide. Pigs were randomly divided into two groups： group A was without orthotopic liver transplantation（ n=6 ）, group B received orthotopic liver transplantation（ n = 5 ）. The clinical manifestations, biochemical, pathological changes and 7-day survival rate of these pigs were investigated. Results In group A,the level of aspartate transaminase, total bilirubin,ammonia and prothrombin time reached to peak at 48h,and the 7-day survival rate was only 17%. The postmortem liver specimens showed a severe hepatocellular necrosis with hemorrhage. In group B,the level of aspartate transaminasw, total bilirubin,ammonia and prothrombin time returned near to normal level on the 7^th postoperative day （POD）in all recipients, and the 7-day survival rate was 100%. The graft liver specimens on POD8 revealed normal liver architecture,mild cloudy swelling degeneration of hepatocytes and minimal inflammatory infiltration in the periportal tracts. Conclusions Orthotopic liver transplantation is an effective method in the treatment of porcine acute hepatic failure. Preoperative correction of coagulation disturbance, utilization of venous-venous bypass and reliable methods of vascular reconstruction are the keys for successful operation.
出处
《肝胆外科杂志》
2006年第2期140-142,共3页
Journal of Hepatobiliary Surgery
关键词
猪
急性肝功能衰竭
肝移植
Pig
Orthotopic liver transplantation
Acute hepatic failure
