摘要
目的 通过动物实验检测肠腔侧侧分流术 (MCS)、远端脾腔分流术 (DSCS)及门奇断流术 (PAD)对门体分流率和肝功能的影响 ,为合理选择手术方式提供理论依据。方法 采用CCl4/乙醇诱导的肝硬变门脉高压大鼠模型行肠腔侧侧分流术 (MCS)、远端脾腔分流术 (DSCS)及门奇断流术(PAD)。观察术前及术后 1、2、3周时的自由门脉压力 (FPP)、门体分流率 (PSS)和肝脏功能的变化。结果 MCS组术后FPP明显下降 ,PSS显著升高 ,肝脏功能进一步恶化 ,至术后 3周仍未恢复 ;DSCS组和PAD组术后FPP及PSS变化较小 ;DSCS组肝脏功能无明显下降 ;PAD组术后 1周肝功能明显下降 ,2周后逐渐恢复到术前状态。结论 远端脾腔分流 (同时施行彻底的脾胰断流 )术有助于维持向肝血流 。
Objective To evaluate the effects of three kinds of operation-mesocaval shunt(MCS), distal splenocaval shunt(DSCS) and portaazygous disconnection(PAD), on the free portal pressure(FPP), portasystemic shunting(PSS) and hepatic function. Methods Using the cirrhotic portal hypertensive rats induced by CCl 4/ethanol, we operated mesocaval shunt(MCS), distal splenocaval shunt(DSCS) and portaazygous disconnection(PAD), and investigated free portal pressure(FPP), portasystemic shunting(PSS) and hepatic function before operation and three weeks after operation. Results The results showed: (1) After MCS, FPP were significantly decreased, and PSS increased, the liver function were deferiorated and didn't restore to the state of preoperation in the third postoperative week. (2) After DSCS and PAD, FPP and PSS were less influenced. (3) After DSCS, the hepatic function wasn't significantly changed. (4) After PAD, the hepatic dysfunction became mae severe in the first postoperative week, and restored to the preoperative state after the senond postoperative week. Conclusions These results indicate that distal splenocaval shunt(DSCS) (with complete splenopancreatic disconnection) could remain bloodflow in the portal vein and protect the liver function.
出处
《消化外科》
CSCD
2004年第1期46-49,共4页
Journal of Digestive Surgery
关键词
肝硬变
门静脉
分流术
断流术
门体分流率
肝脏功能
liver cirrhosis portal vein shunt portaazygos disconnection portasystemic shunting hepatic function
