大鼠肝门部整块切除术后门静脉动脉化重建肝血流的实验模型

目的 子解用门静脉动脉化重建肝血流的可行性。方法 建立门静脉动脉化重建肝脏血流的梗阻性黄疸大鼠实验模型，观察肝脏的结构和功能改变。结果 大鼠胆总管结扎５d后，胆红素（ＢＩＬ）、转氨酶（ＡＬＴ、ＡＳＴ）和碱性磷酸酶（ＡＬＰ）显著增高（与对照组相比，Ｐ＜０.０１），胆总管结扎５d后的大鼠行胆管再通＋门静脉动脉化手术后１周。ＢＩＬ即可恢复正常（与对照组相比，Ｐ＞０.０５），ALT、AST和ALP明显下降，但差异仍有显著意义（Ｐ＜０.０５），手术后１个月即可完全恢复正常（与对照组相比，Ｐ＞０.０５），肝脏结构亦可顺利恢复。结论 门静脉动脉化重建肝血流在临床上有一定的可行性和应用前景。

An experimental study on hilar en bloc resection and reconstruction of hepatic blood flow with arterialization of portal vein in rats with obstructive jaundice

Objective　 In cases of proximal bile duct cancer, radical en bloc resection of the hepatodudenal ligament is sometimes compulsory.This study was undertaken to evaluate the feasibility of arterialization of the portal vein to restore liver blood flow after the radical resection.　Methods 　Experimental model was established in rats with common bile duct ligation. Operative effect on rats was viewed and alterations of liver function and structure was investigated.　 Results　 BIL,ALT,AST and ALP elevated significantly (compared with normal, P＜0.01) on 6 days after common bile duct ligation. BIL became normal (P＞0.05),ALT,AST and ALP fell obviously,but still had significant difference compared with normal (P＜0.05) at one week after bile duct reopening plus arterialization of portal vein, ALT, AST and ALP become normal （compared with normal, P＞0.05） in one month. Liver structure recovered smoothly.　Conclusions　 The method of reconstruction after resection of the hepatodudenal ligament may be applicable for clinical use.