Klar E, Mall G, Messmer K, Herfarth C, Rattner D W, Warshaw A L
Department of General and Experimental Surgery, University of Heidelberg, Germany.
Surg Gynecol Obstet. 1993 Feb;176(2):144-50.
Impairment of the pancreatic microcirculation is a characteristic finding in experimental biliary pancreatitis. Isovolemic hemodilution with dextran 60 has been proven to maintain pancreatic capillary perfusion. To evaluate the significance of this therapeutic approach with respect to histologic changes, intravital microscopic assessment of the microcirculation was combined with a morphometric analysis of the pancreas by means of light microscopy in rabbits (n = 18). Pancreatic capillary perfusion was maintained in the rabbits subjected to hemodilution 30 minutes after the induction of pancreatitis with 54 percent of the capillaries still being perfused at 12 hours, compared with only 16 percent in the control group. The improved capillary perfusion resulted in a significant reduction of those changes considered potentially reversible (cell vacuolization and interstitial edema) that surround zones of necrosis. However, because of the early establishment of necrosis in this model, hemodilution was unsuccessful in preventing all cell death. Hemodilution can limit the progressive extension of pancreatic injury in this model of biliary pancreatitis.
胰腺微循环障碍是实验性胆源性胰腺炎的一个典型表现。已证实用右旋糖酐60进行等容血液稀释可维持胰腺毛细血管灌注。为了评估这种治疗方法对组织学变化的意义，通过活体显微镜对微循环进行评估，并结合光镜对兔胰腺进行形态计量分析（n = 18）。在胰腺炎诱导后30分钟接受血液稀释的兔中，胰腺毛细血管灌注得以维持，12小时时仍有54%的毛细血管在灌注，而对照组仅为16%。毛细血管灌注的改善使坏死区域周围那些被认为可能可逆的变化（细胞空泡化和间质水肿）显著减少。然而，由于该模型中坏死形成较早，血液稀释未能防止所有细胞死亡。在这种胆源性胰腺炎模型中，血液稀释可限制胰腺损伤的进行性扩展。
