脾切除在防治小肝综合征中的作用

 目的探讨小肝综合征发生的内在机制及脾切除对小肝综合征发生的影响。方法建立大鼠小体积肝脏模型。脾切除组切除80%肝组织同时行脾切除,对照组仅行80%肝组织切除,假手术组仅肝脏游离,不做肝切除。检测术后门静脉压力、肝组织肿瘤坏死因子α(TNF-α)和增殖细胞核抗原(PCNA)mRNA和蛋白表达及髓过氧化物酶(MPO)活性、肝功能变化及小肝综合征发生率。结果肝切除后,对照组和假手术组比较门静脉压力明显增高,TNF-αmRNA表达和蛋白表达明显增强,MPO活性明显增高(P<0.05);脾切除组和对照组比较门静脉压力降低,TNF-αmRNA和蛋白表达量、MPO活性均降低(P<0.05),而PCNAmRNA和蛋白表达明显增强(P<0.05)。脾切除组肝功能损害及小肝综合征的发生率和对照组比较显著降低(P<0.05)。结论脾切除能够降低小体积肝脏的门静脉灌流和压力,减少促炎性细胞因子的表达和释放,减轻细胞损害,促进肝再生,降低小肝综合征的发生。

The Role of Splenectomy in the Prevention and Treatment of Small-for-size Syndrome

Objective To explore the pathophysiologic mechanism of the development of a small-for-size syndrome(SFSS)and the role of splenectomy in the prevention and treatment of SFSS.Methods The rat models of sham-operation and 80% partial hepatectomy were established.Totally 144 rats were randomly divided into 3 groups:1) splenectomy group:splenectomy was performed following 80% partial hepatectomy;2)control group:80% partial hepatectomy was performed;3)sham group:no hepatectomy was performed.After the operation, we...