限制流量的部分门静脉动脉化重建肝血流的实验研究

目的 研究限制流量的部分门静脉动脉化(APS)重建肝血流对肝脏的影响.方法 建立APS和限制流量的APS重建肝脏血流的大鼠实验模型,对肝脏血流动力学和结构改变进行为期6个月的对比观察.结果 未采取限制流量的APS术后6个月肝脏血流量(30.6±10.8mV)与术前(22.6±2.8mV)相比,有显著性差异(P＜0.05);门静脉压(18.8±6.3cmH2O)与术前(10.0±0.4cmH2O)相比,有显著性差异(P＜0.01),肝脏结构有一定损害.而限制流量的APS术后6个月肝脏血流量(24.8±6.6mV)与术前(22.8±2.4mV)相比,无显著性差异(P＞0.05);门静脉压(12.2±2.6cmH2O)与术前(9.8±1.6cmH2O)相比,有显著性差异(P＜0.01),而与手术动脉化后(12.4±4.2cmH2O)相比则无显著性差异(P＞0.05),肝脏结构无明显损害.6个月时两组间门静脉压和肝脏血流量比较,均有显著性差异(P＜0.01,P＜0.05).结论 部分门静脉动脉化后限制流量能有效地防止门静脉压和血流量的显著增高,避免过高血流量对肝脏结构的损害.

An experimental study on the reconstruction of hepatic blood flow with flow-restricted arterio-portal shunt

Objective To study the effect of flow-restricted arterio-portal shunt(APS)on the liver.Methods Experimental model of APS and flow-restricted APS were reproduced in rats,and its effects on hepatic blood flow(HBF)and portal venous pressure(PVP)were observed,and the changes in liver structure were investigated six months after the operation.Results Compared with that of pre-operation,both HBF and PVP in APS group at the sixth month after operation changed significantly(P<0.01 and P<0.05,respectively).Histological examination showed out a slight change;and no significant change in HBF was found in flow-restricted APS group at the sixth month after operation(compared with that of pre-operation,P>0.05).The PVP changed significantly(P<0.01)compared with that of pre-operation,while no significant change was found when compared with that of after operation(P>0.05).No obvious lesions were found in the liver by histological examination.Significant differences of both PVP and HBF were found at the sixth month between the two groups(P<0.01 and P<0.05,respectively).Conclusion Flow-restricted APS may have a positive effect on preventing the scale-up of HBF and PVP,and obviating the injury of hepatic structure induced by over inflow.