摘要
目的观察主肝静脉阻断后保留肝段的病理形态学变化。方法７８只大鼠随机分为对照组、肝段静脉结扎组、左主肝静脉缩窄组与结扎组，动态观测受累肝叶的病理学，肝脏微循环与血流动力学变化。结果主肝静脉结扎后２４小时即发生肝细胞坏死，门静脉血内毒素与ＴＸＢ２／６－Ｋｅ－ｔｏ－ＰＧＦ１α明显升高，主肝静脉缩窄组受累肝叶边缘大量肝静脉与门静脉侧支形成，门静脉血内毒素与ＴＸＢ２／６－Ｋｅｔｏ－ＰＧＦ１α也发生不同程度升高，两组均明显高于肝段静脉结扎组与对照组。结论正常肝组织不能耐受主肝静脉急性阻断，无肝静脉引流的肝组织不但完全丧失功能，而且引起内毒素血症与肝脏微循环障碍，主肝静脉结扎应同时将引流肝段切除。
Objective To observe the pathological changes of the remained hepatic lobe after major hepatic vein(MHV) occlusion. Method Seventyeight rats were randomly divided into the control group, the ligation group of segmental hepatic vein, the stricture group of left MHV, and the ligation group of left MHV. The pathology, hepatic microcirculation and hemodynamic changes of the involved hepatic lobe of MHV occlusion were dynamiclly determined. Result Necrosis occurred in the hepatocytes at the first postoperative day in the ligation group of MHV. Extensive collaterals between the hepatic veins and the portal veins appeared in the periphery of involved liver lobe in the stricture group of MHV. The levels of endotoxin and TXB2/6KetoPGF1α in the blood of portal vein obviously increased in the ligation group of MHV and also increased in the stricture group of MHV. The levels of endotoxin and TXB2/6KetoPGF1α in the blood of portal vein in the ligation and stricture group of MHV were apparently higher than those in the ligation group of segmental hepatic vein and in the control group. Conclusion The involved liver tissue can not tolerate complete MHV occlusion. The hepatic tissue lacking of MHV drain not only loss its function, but also cause endotoxemia and disorder of hepatic microcirculation. The involved hepatic lobe after the MHV ligation should have been resected at the same time.
出处
《中华外科杂志》
CAS
CSCD
北大核心
1998年第7期421-423,共3页
Chinese Journal of Surgery
关键词
肝静脉
肝切除术
血流阻断
Hepatic vein Liver resection Blood flow occlusion
