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犬短期肝静脉流出道阻塞后的酶学和血流动力学变化

Enzymatic and hemodynamic changes after short term hepatic outflow occlusion in the dog.

作者信息

Nagasue N, Inokuchi K

出版信息

Surg Gynecol Obstet. 1977 Feb;144(2):179-84.

PMID:13503
Abstract

In normal mongrel dogs, outflow occlusion of 15 or 30 minutes duration was produced by clamping both the suprahepatic and suprarenal portions of the vena cava. One dog died immediately after release of occlusion; two dogs died from recurrent hypotension between six and 24 hours postoperatively. The other five dogs survived for three days, at which time an autopsy was done. During outflow occlusion, the blood pressure fell in all dogs, as did the central venous pressure. The pulse rate decreased during, and after, occlusion but toward a tendency of gradual recovery. A significant drop in pH and base excess of arterial blood was seen after occlusion. Although a steady, but not substantial, increase in hemoglobin and hematocrit values was noted, there were no remarkable changes in the blood coagulation system. Significant increases in serum glutamic-oxalacetic transaminase, glutamic-pyruvic-transaminase, lactic dehydrogenase, acid phosphatase and beta-glucuronidase activities were observed from immediately after release of occlusion, but alkaline phosphatase values increased much later than did these. Thus, hepatic outflow occlusion, even if it is short, seems to be dangerous in the dog, since it produces hypotension, metabolic acidosis and diffuse damage as well as disruption of the parenchyma of the liver.

摘要

在正常杂种犬中,通过钳夹肝上和肾上腺上方的腔静脉部分造成持续15或30分钟的流出道阻塞。一只犬在阻塞解除后立即死亡;两只犬在术后6至24小时死于反复性低血压。另外五只犬存活了三天,此时进行了尸检。在流出道阻塞期间,所有犬的血压均下降,中心静脉压也下降。阻塞期间及之后脉搏率降低,但有逐渐恢复的趋势。阻塞后可见动脉血pH值和碱剩余显著下降。尽管血红蛋白和血细胞比容值有稳定但不显著的升高,但凝血系统无明显变化。阻塞解除后立即观察到血清谷草转氨酶、谷丙转氨酶、乳酸脱氢酶、酸性磷酸酶和β-葡萄糖醛酸酶活性显著升高,但碱性磷酸酶值比这些酶升高晚得多。因此,即使肝流出道阻塞时间很短,在犬中似乎也是危险的,因为它会导致低血压、代谢性酸中毒、弥漫性损伤以及肝实质破坏。

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