Kogure K, Suzuki M
First Department of Surgery, Gunma University, School of Medicine, Maebashi, Japan.
Circ Shock. 1992 Apr;36(4):290-8.
To evaluate the effects of hepatic inflow occlusion without the shunt, the physiological differences were compared in three groups of rats in which the hepatoduodenal ligament was occluded for 15 min, 30 min, and 60 min. The survival rate significantly decreased in the 60 min occlusion group (53.6%) when compared with that of the 15 min and 30 min occlusion groups (95% and 91.6%, respectively). The significant differences in the changes in blood pressure (BP), the values of plasma potassium, histamine (HIS), norepinephrine (NE), aspartate aminotransferase (AST), alanine aminotransferase (ALT), and the values of hematocrit (HT) were also observed between the 30 min and 60 min occlusion groups. The results indicate that, in rats, there is a high probability of an irreversible state to shock after 30 min hepatic inflow occlusion when veno-venous bypass is not applied. The values of plasma HIS and NE and the values of HT in portal blood were significantly greater than those in the general circulation. The results suggest that splanchnic congestion may have a greater influence than hepatic ischemia has in contributing to the deterioration of the physiological state.
为评估无分流情况下肝血流阻断的效果，对三组大鼠的生理差异进行了比较，这三组大鼠的肝十二指肠韧带分别阻断15分钟、30分钟和60分钟。与15分钟和30分钟阻断组（分别为95%和91.6%）相比，60分钟阻断组的存活率显著降低（53.6%）。在30分钟和60分钟阻断组之间还观察到血压（BP）变化、血浆钾、组胺（HIS）、去甲肾上腺素（NE）、天冬氨酸转氨酶（AST）、丙氨酸转氨酶（ALT）的值以及血细胞比容（HT）值的显著差异。结果表明，在大鼠中，当不进行静脉-静脉旁路时，肝血流阻断30分钟后发生不可逆休克状态的可能性很高。门静脉血中的血浆HIS和NE值以及HT值显著高于体循环中的值。结果表明，内脏充血对生理状态恶化的影响可能比肝缺血更大。
