肾静脉上结扎大鼠下腔静脉的心脏血流动力学改变和川芎嗪对其的影响

目的 探讨肾静脉平面以上结扎大鼠下腔静脉及应用川芎嗪后的心脏血流动力学改变。方法 在肾静脉平面以上结扎大鼠下腔静脉及川芎嗪治疗，术后1、6、24、48h检测心率、射血分数、心输出量、每搏输出量、鼠尾动脉压等心脏血流动力学指标。结果 单纯结扎大鼠下腔静脉后心输出量减少、血压下降，但至术后48h可完全代偿，动物全部存活。结扎下腔静脉并川芎嗪治疗术后心输出量减少、血压下降，但术后24h即可完全代偿，动物全部存活。结论 肾静脉平面以上结扎大鼠下腔静脉可使回心血量急骤减少而影响心功能，但术后48h即可完全代偿。若结扎下腔静脉同时加用川芎嗪治疗，可明显改善心功能状况。建议当腹膜后肿瘤侵及肾静脉平面以上的下腔静脉时，切除肿瘤及其累及下腔静脉段后，可直接结扎下腔静脉，同时加用川芎嗪治疗，无需附加健康右肾切除。术后早期应注意经上肢浅静脉补充液体以增加回心血量。

Cardiac hemodynamics following suprarenal ligation of the inferior vena cava and injection of ligustrazine in rats

Objective To investigate the cardiac hemodynamics following suprarenal I/gation of the inferior vena cava IVC and injection of ligustrazine in rats. Methods Heart rate, ejection fraction, cardiac output, stroke volume, arterial pressure were recorded at 1st, 6th, 24th and 48th h after the suprarenal ligation of the IVC and injection of ligustrazine. Results Cardiac output and arterial pressure were reduced following the suprarenal ligation of the IVC, hut compensated completely at 48th h after the operation. All rats in this group survived during the study period. Cardiac outputand artierial pressure were reduced following the suprarenal ligation of the IVC and injection of ligustrazine, but compensated quickly at 24th h after the operation, and all rats survived in this group. Conclusion Cardiac funtions are affected by low returned blood volume following the suprarenal ligation of the IVC, but compensated completely at 48th h after the operation. The suprarenal ligation of the IVC and injection of ligustrazine can improve cardiac funtion of the experimental rats. We suggest to ligate the suprarenal IVC after resecting the tumor and infiltrated IVC and inject ligustrazine, not to resect nomal right kidney. To infuse solution by upper limb in early phase after the operation can increase returned blood volume.