肝硬化大鼠ALPPS模型的建立

目的建立肝硬化大鼠联合门静脉结扎与原位肝脏劈离的二步肝切除术（ALPPS）模型，探讨ALPPS的可行性。方法采用四氯化碳腹腔注射法建立肝硬化大鼠模型，建模成功后，50只肝硬化SD大鼠行ALPPS，选择性结扎大鼠右叶、尾叶、左外叶、左内叶门静脉分支，保留中叶及乳头叶血供，行肝中叶及左内叶肝实质劈离，大鼠以术后存活7d以上视为建模成功。结果50只肝硬化建模大鼠，ALPPS术后存活40只，手术时间（26.75±12.15）min；死亡原因主要为术前麻醉过深，术中失血、膈肌穿孔、下腔静脉损伤、肝静脉分支损伤，术后肝功能衰竭、胆瘘、腹腔感染；存活大鼠7d后处死可见肝右中叶明显增大。肝硬化大鼠ALPPS建模成功率为80.0%。结论在四氯化碳腹腔注射法建立的肝硬化大鼠模型上行ALPPS是安全可行的，可增大术后肝脏剩余体积。

Establishment of ALPPS model in cirrhotic rats

Objective To establish associating liver partition with portal vein ligation for staged hepatectomy (ALPPS) model in cirrhotic rats. Methods The rat cirrhosis induced by intraperitoneal injection of CCl4. After cirrhosis was established, the right lobe, caudate lobe, left lateral lobe and left inner lobe branches of portal veins were ligated, the middle lobe and papilla lobe branches of portal veins were retained. Liver partition was performed in the middle of right lobe and the left inner lobe. The survival of the animals more than 7 days after surgery was defined as success of the modeling. Results The average operative time of ALPPS was (26.75 ± 12.15) min. Forty out of the 50 rats survived for more than 7 days with a success rate of 80%. The causes of preoperative death mainly were anesthesia; those for intraoperative death were bleeding, perforation of diaphragm, inferior vena cava and hepatic vein injury; those for postoperative death were liver failure, biliary fistula and abdominal infection. Conclusion It is safe and feasible to establish the ALPPS model in rats with CCl4-induced cirrhosis.