Maeda K
Second Department of Surgery, Kanazawa University School of Medicine, Japan.
Nihon Geka Gakkai Zasshi. 1991 Jun;92(6):697-706.
The influence of hepatic arterial obstruction on the hepatic circulation and tissue metabolism was studied between animals with and without partial arterialization of the portal vein. Mongrel dogs were divided into these groups: a group in which the collaterals to the liver were obstructed and the hepatic artery was dissected (hepatic artery ligated group); two groups in which an extracorporeal femoral artery-portal vein shunt was produced, and blood was sent by a Biopump at a rate of 100 or 200 ml/min (100 ml/min and 200 ml/min portal arterialized groups). The hepatic artery ligated group showed CO2 accumulation and acidosis in hepatic venous blood, reduction of oxygen supply, increase of oxygen consumption and marked increase of GOT and GPT. In the portal arterialized groups, sufficient oxygenation of portal blood was noted, and the oxygen demand and supply and tissue metabolism were kept approximately normal. The optimum flow rate for partial arterialization of the portal vein seemed to be 100 ml/min. At the flow rate of 200 ml/min, the original portal blood was reduced, leading to portal hypertension and increase of GOT and GPT. These results indicate that partial arterialization of the portal vein effectively preserves the liver function during the operation and in the early period after dissection of the hepatic artery.
在门静脉部分动脉化和未部分动脉化的动物之间,研究了肝动脉阻塞对肝循环和组织代谢的影响。杂种犬被分为以下几组:一组是肝侧支循环被阻断且肝动脉被解剖(肝动脉结扎组);两组是建立了体外股动脉-门静脉分流,并用生物泵以100或200ml/min的速率输送血液(100ml/min门静脉动脉化组和200ml/min门静脉动脉化组)。肝动脉结扎组肝静脉血中出现二氧化碳蓄积和酸中毒,氧供应减少,氧消耗增加,谷草转氨酶(GOT)和谷丙转氨酶(GPT)显著升高。在门静脉动脉化组中,门静脉血得到了充分的氧合,氧需求、供应和组织代谢大致保持正常。门静脉部分动脉化的最佳流速似乎为100ml/min。在流速为200ml/min时,原来的门静脉血减少,导致门静脉高压以及GOT和GPT升高。这些结果表明,门静脉部分动脉化在肝动脉解剖手术期间及术后早期能有效保护肝功能。