入肝血流阻断和全肝血流阻断对胆道梗阻兔肝脏损伤的研究

目的 研究入肝血流阻断和全肝血流阻断对胆道梗阻兔肝脏的缺血-再灌注损伤。方法 36只兔随机均分为3组:胆道梗阻组(A组,BCDL)、入肝血流阻断组(B组,PTC)和全肝血流阻断组(C组,THVE)。组织气体分析仪持续测定肝组织氧分压(P_(ti)O_2);全自动生化仪测定血流总胆红素(TBIL)、丙氨酸氢基转氨酶(ALT);光镜观察肝脏病理改变。结果 B、C组在肝血流阻断后,肝 P_(ti)O_2值均明显下降,再灌注 60 min仅恢复到缺血前的 87.5％和 73.4％(P<0.05),C组较 B组肝P_(ti)O_2 值恢复更慢(P<0.05)。B、C两组 ALT值在肝缺血-再灌注期间均有不同程度升高,C组ALT值升高更明显,且与肝细胞损伤的病理学改变相一致。结论 急性胆道梗阻兔行PTC和THVE均可导致肝脏缺血-再灌注损伤,PTC较THVE对肝脏的损伤明显减轻。

Effect of portal triad clamping and total hepatic vascular exclusion on liver in rabbits with cholestasis

Objective To explore the effect of portal triad clamping (PTC) and total hepatic vas- cular exclusion (THVE) on liver in rabbits with cholestasis. Methods Thirty-six rabbits were divided into three groups: cholestasis, PTC and THVE. During liver ischemia and reperfusion, hepatic tissue oxy- gen pressure (P_(ti)Q_2) was monitored. Serum total bilirubin (TBIL) and glutamic-pyruvic transaminase (ALT) were also measured. The histopathologic hepatic changes were observed. Results Hepatic P_(ti)O_2 value in PTC group at different time points of liver ischemia-reperfusion was significantly higher than in THVE group. In PTC group serum ALT levels were increased to varying degrees identical to the histopathologic hepatic injury, but lower then in THVE group. Conclusion PTC can increase hepatic P_(ti)Q_2 value and lead to a lesser degree of hepatocyte injury in rabbit with cholestasis.