摘要
目的 采用不同药物区域动脉灌注 ,观察对重症急性胰腺炎 (SAP)肝损伤的保护作用。方法 复制大鼠SAP模型 ,随机分组后经股动脉插管至腹腔动脉开口处 ,分别给予善宁 (奥曲肽 )、改善微循环药物及两种药物联合持续动脉灌注 ,观察胰腺、肝脏病理改变及血淀粉酶、肝功能的变化。结果 模型建立后 6小时各项检查指标明显升高 ,胰腺坏死、出血 ,肝脏充血、水肿并有坏死。应用善宁降低了血清淀粉酶 ,肝功能指标也有改善 ,胰腺水肿渗出减轻 ,出血坏死情况改善不明显 ,肝脏瘀血坏死情况有所好转。应用改善微循环药物降低了血清淀粉酶及肝功能指标 ,胰腺水肿、坏死得到改善 ,肝脏瘀血、坏死减轻。两种药物联合应用明显降低淀粉酶及肝功能指标 ,胰腺、肝脏病理情况也得到明显改善。结论 区域动脉药物灌注是治疗SAP的有效方法 ,对肝损伤具有保护作用。
Objective To investigate a more ra ti onal modality which is in the treatment of severe acute pancreatitis (SAP) an d effective in preventing liver from damages due to SAP. Methods SAP model was established by retrograd e injection of 5% sodium taurocholate (1.0 ml) in the subserosa of pancreas in rats (n=80) weighting 200-250 g.The rats were catheterized using PE-50 angiocatheter from femoral artery to celiac trun k. Then they were randomly divided into four groups. Twenty animals served as co ntrols (A group) and received only fluid infusion. The 40 animals, B and C grou p (20 animals in each one group) received continuous regional arterial infusion (CRAI) of somatostatin (4 μɡ/kg) and the medicines improving microcirculat ory (dextran-40 1.5 ml, dopamine hydrochloride 5 μg/kg, anisodaminum 1.5 ml/kg ) respectively. The other 20 animals (D group) were treated by somatostatin com bined with the medicine improving microcirculatory through CRAI simultaneously with the induction of pancreatitis. The AST, ALT, ALP and serum amylase were re corded, the liver and pancreas tissue were observed pathologicaly after 6 hours . Results There were a significant decrease in th e serum amylase in B group (P<0.05) and D group (P<0.05). The AST, ALT, ALP was decreased in B and D group (P<0.05). The damage to liver and pancre as were reduced in D group. Conclusion CRAI is effective in preventing liv er damages due to SAP and is an effective way in the treatment of SAP.
出处
《中国普外基础与临床杂志》
CAS
2001年第6期375-377,共3页
Chinese Journal of Bases and Clinics In General Surgery
