Shimokawa S
Second Department of Surgery, Kagoshima University School of Medicine, Japan.
Nihon Geka Gakkai Zasshi. 1989 May;90(5):695-704.
Hemodynamic changes of portal and hepatic circulation in dogs with chronic congestive liver (CCL) have been studied with reference to cardio-pulmonary (C-P) bypass. The CCL dogs were provided by means of cut of the chordae of tricuspid valve followed by breeding for 4 to 41 months. Five of CCL dogs and 10 of control dogs were served for C-P bypass for 90 minutes. The measurements of portal venous pressure (PVP), wedged hepatic venous pressure (WHVP) and hepatic tissue blood flow (HBF) by hydrogen gas clearance method were made before and during C-P bypass. Results were as follows. 1. HBF of CCL dogs after laparotomy decreased significantly (p less than 0.001) in comparison of control dogs (31.7 +/- 14.4 vs. 62.7 +/- 23.3 ml/min/100g). 2. During the C-P bypass, the rates of rise of PVP and WHVP in CCL dogs revealed a lesser prominent than those of control dogs. 3. No reduction of the HBF was seen during the C-P bypass in CCL dogs. These results lead the conclusion that the portal and hepatic circulation of CCL dogs poorly adapted to an unphysiological condition of C-P bypass. It is considered, however, that CCL itself is not a state of absolute contraindication for C-P bypass in open cardiac surgery.
参照体外循环，对患有慢性充血性肝病（CCL）的犬的门静脉和肝循环的血流动力学变化进行了研究。CCL犬是通过切断三尖瓣腱索并繁殖4至41个月获得的。5只CCL犬和10只对照犬进行了90分钟的体外循环。在体外循环前后，通过氢气清除法测量门静脉压力（PVP）、肝静脉楔压（WHVP）和肝组织血流量（HBF）。结果如下：1.与对照犬相比，剖腹术后CCL犬的HBF显著降低（p<0.001）（31.7±14.4 vs.62.7±23.3 ml/min/100g）。2.在体外循环期间，CCL犬的PVP和WHVP升高速率不如对照犬显著。3.在体外循环期间，CCL犬的HBF未见降低。这些结果得出结论，CCL犬的门静脉和肝循环对体外循环这种非生理状态适应性较差。然而，有人认为，CCL本身并非心脏直视手术中体外循环的绝对禁忌状态。
