肝内不同途径移植微囊对门静脉血流动力学影响的实验研究

目的:运用彩色多普勒超声研究肝内不同途径移植微囊对门静脉血流动力学的影响.方法:健康雄性成年狗30只,分为经门静脉移植组(PV组)和经肝动脉移植组(HA组),每组各15只.每组根据移植的微囊剂量(8 000个/kg,16 000个/kg,32 000个/kg)再各分为3小组(PV1,PV2,PV3及HA1,HA2,HA3),每小组各5只.移植手术前及术后24 h、1周、2周、4周分别采用彩色多普勒超声技术测量实验狗的门静脉主干内径、血流速度并抽取静脉血检测谷丙转氨酶(ALT)水平.结果:PV1和PV2组微囊移植后24 h门静脉主干内径无显著改变,而血流速度显著增快(P＜0.05);PV3组微囊移植后24 h门静脉主干内径显著增大(P＜0.05),血流速度显著减慢(P＜0.05).不同微囊剂量肝动脉移植组内、组间门静脉血流动力学变化无统计学意义(P＞0.05).移植术后24 h,PV和HA组ALT水平均明显升高(P＜0.05);且相同移植剂量时,PV组较HA组升高明显(P＜0.05).结论:肝动脉移植途径较门静脉移植途径安全性高、移植物数量耐受量大.

Experimental study of portal hemodynamics after microcapsule transplantation by intraportal and transarterial approach

Objective To compare the changes of portal hemodynamics after microcapsule transplantation by intraportal and transarterial approach with color doppler sonography.Methods Thirty male dogs were divided into 2 groups randomly:Group PV(microcapsules implanted into the portal vein)and Group HA(microcapsules implanted into the hepatic artery).Both groups were divided into 3 subgroups(PV1,PV2,and PV3;HA1,HA2,and HA3)according to the number of implanted microcapsules(8 000/kg,16 000/kg,and 32 000/kg).The internal diameter and flow velocity of the portal vein were measured with color doppler sonography before the transplantation,within 24 hours and 1,2,and 4 weeks after microcapsule transplantation.Results The flow velocity of the portal vein in Group PV1 and PV2 within 24 hours increased significantly(P <0.05);The meanwhile the internal diameters did not change significantly(P >0.05).The flow velocity of the portal vein in Group PV3 within 24 hours decreased significantly(P <0.05),but the internal diameter increased significantly(P <0.05).Portal hemodynamics of different transarterial subgroups did not change significantly(P >0.05).The level of ALT in Group PV and Group HA all increased significantly(P <0.05).And when the numbers of microcapsule transplantation were same,the level of ALT in subgroup PV were significantly higher than that in subgroup HA(P <0.05).Conclusion Microcapsule transplantation by transarterial approach is safer than by intraportal way,and the hepatic artery can contain more microcapsule than the portal vein.