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多巴胺可代偿肝动脉阻断及再灌注期间肝脏血流动力学和代谢的恶化。

Dopamine compensates for deterioration of hepatic hemodynamics and metabolism during occlusion and reperfusion of the hepatic artery.

作者信息

Kurokawa T, Nonami T, Ujita T, Harada A, Nakao A, Takagi H

机构信息

University School of Medicine, Department of Surgery II, Nagoya, Japan.

出版信息

Arch Surg. 1995 Oct;130(10):1085-9. doi: 10.1001/archsurg.1995.01430100063013.

Abstract

OBJECTIVE

To investigate the effects of temporary hepatic arterial occlusion and dopamine on hepatic hemodynamics and metabolism.

DESIGN

Experimental animal study in a dog model. The proper hepatic artery was occluded for 60 minutes; then, it was reperfused for 60 minutes. Hepatic hemodynamic and oxygen metabolic values, lactate uptake ratios, and blood glucose levels were determined repeatedly throughout the experiment. Data are given as mean +/- SE.

INTERVENTION

In another group, dopamine hydrochloride, 10 micrograms/kg per minute, was infused intravenously throughout the experiment, and the same variables were recorded.

RESULTS

Portal vein blood flow continuously decreased during occlusion, and it decreased even further after declamping of the hepatic artery; this led to a disturbance of oxygen and lactate metabolism in the control group. Dopamine increased the portal vein blood flow from 84.9% +/- 3.9% to 100.9% +/- 3.6% of the preocclusion levels after 60-minute occlusion and from 79.0% +/- 3.6% to 93.6% +/- 5.1% of the preocclusion levels after 60-minute reperfusion (P < .05, respectively). Dopamine also enhanced the hepatic oxygen uptake ratio from 112.8% +/- 12.0% to 150.7% +/- 11.6% of the preocclusion levels after 60-minute reperfusion (P < .05, respectively). These factors contributed to acceleration of the hepatic oxygen consumption and lactate uptake ratio in the group of dogs that were infused with dopamine.

CONCLUSIONS

Temporary occlusion of the hepatic artery causes deterioration of hepatic hemodynamics and metabolism. Administration of dopamine is an effective way to support hepatic function during occlusion of the hepatic artery.

摘要

目的

探讨临时肝动脉阻断及多巴胺对肝脏血流动力学和代谢的影响。

设计

以犬为模型的实验性动物研究。将肝固有动脉阻断60分钟;然后再灌注60分钟。在整个实验过程中反复测定肝脏血流动力学和氧代谢值、乳酸摄取率及血糖水平。数据以均值±标准误表示。

干预

另一组在整个实验过程中静脉输注每分钟10微克/千克的盐酸多巴胺,并记录相同的变量。

结果

在阻断期间门静脉血流持续减少,肝动脉夹闭解除后进一步减少;这导致对照组氧和乳酸代谢紊乱。多巴胺使门静脉血流在阻断60分钟后从阻断前水平的84.9%±3.9%增加至100.9%±3.6%,在再灌注60分钟后从阻断前水平的79.0%±3.6%增加至93.6%±5.1%(P均<0.05)。多巴胺还使肝脏氧摄取率在再灌注60分钟后从阻断前水平的112.8%±12.0%提高至150.7%±11.6%(P均<0.05)。这些因素促使输注多巴胺的犬组肝脏氧耗和乳酸摄取率加快。

结论

临时阻断肝动脉会导致肝脏血流动力学和代谢恶化。给予多巴胺是在肝动脉阻断期间支持肝功能的有效方法。

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