Joyeux H, Joyeux A, Raoux P, Brissac C, Blanc F, Solassol C
Ann Anesthesiol Fr. 1977;18(11):939-47.
Anhepatia is a complete experimental model for the study of metabolic disturbances associated with hepatic insufficiency. The authors report their experience based upon 16 cases of total hepatectomy in the dog. The animals received different types of hepatic assistance : group 1 (2 dogs), carbohydrate assistance (glucose 7 g/kg/24 h) ; group II (2 dogs), carbohydrate and haemostatic assistance : homologous plasma 50 ml/kg body weight per 24 hours previously stored at - 80 degrees C ; group III (2 dogs) same nutrition as in group II, combined with amino acids : leucine 53, 3 mg, isoleucine 46, 6 mg ; valine 53,3 mg alpha-ketonic acid (lg/kg/24 h) ; group IV (10 dogs, same nutrition as in group III, combined with supplements in neuro transmitter precursors : 6 dopa 1,66 mg, 5 hydroxy-tryptophane 2 mg and choline 16, 66 mg/kg/24h. Metabolic disturbances and their course were analysed in detail. Results : (mean survival) - group I : 24 +/- 4 hours; group II : 36 +/- 9 hours; group III : 42 +/- 4 hours; group IV : 90 +/- 9 hours. The average survival differed significantly for groups III and IV (p less than 0,01) in comparison with control groups I and II. The replacement of essential hepatic functions such as blood glucose regulation, coagulation, detoxication and the provision of neurotransmitter precursors made possible 4 days survival after total hepatectomy.
肝缺失是用于研究与肝功能不全相关的代谢紊乱的完整实验模型。作者报告了基于16例犬全肝切除术的经验。动物接受了不同类型的肝脏辅助:第一组(2只犬),碳水化合物辅助(葡萄糖7g/kg/24小时);第二组(2只犬),碳水化合物和止血辅助:每24小时给予50ml/kg体重的同源血浆,血浆预先储存在-80℃;第三组(2只犬),与第二组营养相同,联合氨基酸:亮氨酸53.3mg、异亮氨酸46.6mg、缬氨酸53.3mg、α-酮酸(1g/kg/24小时);第四组(10只犬),与第三组营养相同,联合神经递质前体补充剂:6-多巴胺1.66mg、5-羟色氨酸2mg和胆碱16.66mg/kg/24小时。详细分析了代谢紊乱及其过程。结果:(平均存活时间)——第一组:24±4小时;第二组:36±9小时;第三组:42±4小时;第四组:90±9小时。与对照组第一组和第二组相比,第三组和第四组的平均存活时间有显著差异(p<0.01)。替代肝脏的基本功能,如血糖调节、凝血、解毒以及提供神经递质前体,使得全肝切除术后能够存活4天。