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肝动脉栓塞后门静脉血流动力学变化的实验研究

[Experimental study of portal hemodynamic changes after hepatic artery embolization].

作者信息

Luo B M

机构信息

Digestive Department, Memorial Hospital, Sun Yat-Sen University of Medical Sciences, Guangzhou.

出版信息

Zhonghua Yi Xue Za Zhi. 1993 Jun;73(6):346-8, 381.

PMID:8258104
Abstract

We studied portal hemodynamic changes by using duplex Doppler in 10 pigs with hepatic artery embolization (HAE) and hepatic artery ligation (HAL) and in 5 with HAL only. Serum concentration of alkaline phosphatase, ALT, direct and indirect bilirubin were determined simultaneously. Hepatic angiography and hepatic vascular cast were performed in the 5 pigs, and pathological examination in others. Portal venous velocity (PVV) and portal blood flow (PBF) increased after HAE, ALP, ALT, direct indirect bilirubin slightly elevated (P > 0.05) in the two groups after operation and most of them decreased subsequently within 7 days. Linear regression of PBF with ALP, ALT, direct and indirect bilirubin occurred in the experimental group. Liver necrosis was seen in all pigs of the experimental group and only one in the control group. Angiography and vascular cast showed that hepatic artery collaterals occurred at the portal hilus in the two groups and were more rich in the control group. Extrahepatic and intrahepatic arterial collaterals were seen from 1 to 3 weeks after HAE. The estimation of PVV and PBF by duplex Doppler may reflect the development of collaterals indirectly and is helpful in assessing the effect of HAE.

摘要

我们采用双功多普勒研究了10只接受肝动脉栓塞(HAE)和肝动脉结扎(HAL)的猪以及5只仅接受HAL的猪的门静脉血流动力学变化。同时测定血清碱性磷酸酶、谷丙转氨酶、直接胆红素和间接胆红素浓度。对5只猪进行了肝血管造影和肝血管铸型,对其他猪进行了病理检查。HAE后门静脉流速(PVV)和门静脉血流量(PBF)增加,两组术后碱性磷酸酶、谷丙转氨酶、直接胆红素和间接胆红素略有升高(P>0.05),且大多数在7天内随后下降。实验组PBF与碱性磷酸酶、谷丙转氨酶、直接胆红素和间接胆红素呈线性回归。实验组所有猪均出现肝坏死,而对照组仅1只猪出现肝坏死。血管造影和血管铸型显示,两组在肝门处均出现肝动脉侧支循环,且对照组更为丰富。HAE后1至3周可见肝外和肝内动脉侧支循环。双功多普勒对PVV和PBF的评估可能间接反映侧支循环的形成,有助于评估HAE的效果。

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