门静脉动脉化及部分肝切除术对肝硬化的影响(1)
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【摘要】 目的 研究行部分肝切除术后PVA对肝硬化的影响,证实PVA能促进部分肝切除术后肝细胞再生,改善肝硬化。方法 肝硬化模型犬随机分三组,A组肝脏42%切除+门静脉动脉化;B组肝脏42%切除;C组对照组。实验中按计划行多普勒超声检查,血化验研究肝功能变化,检测血管内皮细胞标记抗原CD34。结果 A组肝重显著高于B组(P<0.01);A组肝功能的改善亦加快;血流动力学改变在术后A组高于其余二组;免疫组化检测血管内皮细胞标记抗原CD34计数A组高于其余二组。结论 ①门静脉动脉化有助于部分肝切除术后肝功能的改善;②门静脉动脉化增加肝细胞再生及改善肝硬化。
【关键词】
门静脉动脉化;肝硬化
The effects of portal vein arterialization and party hepatectomy to the hepatocirrhosis
ZHOU Qiang,PENG Yubing.The Eighth people’s Hospital of Shanghai,Shanghai 200235,China
【Abstract】 Objective To investigate the effects of portal vein arterializations(PVA)on hepatocirrhosis after party hepatectomy,proved that the PVA can increase the regeneration after party hepatectomy,and improve the hepatocirrhosis.Methods The cirrhosis model dogs were allocated randomly into three groups,dogs in group A received PVA after 42%liver resection,in group B underwent 42%liver resection only,group C was control group.During the experiment,Before operation,we used the color Doppler senograph to measure the hemodynamic change,the blood was taken to study the alteration of liver function and we use the immunohistochemical technique to exam CD34 of specimens.Results In group A liver weight is significant higher than group B(P<0.01)。The improvement ofliver function was also faster in group A。The blood flew of group A was higher than other two groups in 2 ds(P<0.05).In group A the vascular area defined by endothelial cells that stained for CD34 was higher than two groups.Conclusion ①The portal vein arterializations improve the cirrhosis liver function after partyhepatectomy.②The portal vein arterializations increase the liver regeneration and improve the hepatocirrhosis.
【Key words】
Portal vein arterializations; Hepatocirrhosis
DOI:10.3760/cma.j.issn 16738799.2010.01.12
作者单位:200235上海市第八人民医院
肝硬化是一种或多种因素长期或反复损伤肝脏实质,导致结缔组织弥漫性增生伴有肝细胞结节状再生的慢性过程[1]。目前唯一的根治手段是肝移植。临床对肝硬化的治疗,以各种药物缓解硬化进程,防止并发症为主,外科不同方式的分流和断流手术,只能对症处理门脉高压引起的脾亢、腹水、静脉曲张破裂等并发症。在临床和实验治疗肝功能衰竭和部分肝移植的医疗实践中,使用控制性的门静脉动脉化技术被证实是一种有效改善肝细胞功能的手段。
本课题使用文献2的方法制作犬肝硬化模型,随机分为3组,给予不同的手术处理,验证门静脉动脉化是否能缓解肝硬化程度,促进肝脏再生,从而探讨一种可能的新的治疗肝硬化的外科手段。
1 材料与方法 ......
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