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在犬类暂时性肠动静脉闭塞期间进行门腔分流术的手术操作。

Surgical creation of portacaval shunts during temporary intestinal arterial and venous occlusion in dogs.

作者信息

Allen S W, Laflamme D P, Huber T L, Prasse K W

机构信息

Department of Small Animal Medicine, College of Veterinary Medicine, University of Georgia, Athens 30602, USA.

出版信息

Am J Vet Res. 1996 Apr;57(4):588-91.

PMID:8712529
Abstract

OBJECTIVE

To surgically create complete portacaval shunts in dogs during temporary arrest of intestinal arterial and portal venous blood flow.

DESIGN

Complete portacaval anastomoses were surgically created, and liver function was evaluated for 14 to 18 weeks after surgery.

ANIMALS

32 adult mixed-breed dogs of either sex.

PROCEDURE

Administration of deferoxamine and temporary intestinal arterial occlusion were used to minimize the intestinal cellular damage resulting from the complete, temporary arrest of portal venous blood flow during creation of the portacaval anastomosis. Side-to-side, appositional anastomoses ( > 2 cm diameter) were formed between the portal vein and caudal vena cava. Dogs were observed daily for signs of hepatic encephalopathy, and food intake was recorded. Body weight was recorded weekly. Preprandial plasma ammonia, serum urea nitrogen, and glucose concentrations and sulfobromophthalein retention were measured monthly. The dogs were euthanatized, and necropsy was performed 14 to 18 weeks after surgery.

RESULTS

30 of 32 dogs recovered without complications. Complete portosystemic shunting was documented by increased plasma ammonia concentration, decreased serum urea nitrogen and glucose concentrations, prolonged sulfobromophthalein retention (P < 0.01), and inspection at necropsy.

CONCLUSION

This method of providing temporary, complete arrest of portal venous blood flow was helpful in allowing accurate, appositional portacaval anastomoses to be created that remained patent for 14 to 18 weeks.

CLINICAL RELEVANCE

This method of providing temporary, complete arrest of portal venous blood flow may prove useful in clinical surgery when temporary arrest of portal blood flow is desired.

摘要

目的

在肠道动脉和门静脉血流暂时阻断期间,通过手术在犬体内建立完全性门腔分流。

设计

通过手术建立完全性门腔吻合,并在术后14至18周评估肝功能。

动物

32只成年杂种犬,雌雄不限。

步骤

使用去铁胺并暂时阻断肠道动脉,以尽量减少在建立门腔吻合期间门静脉血流完全、暂时阻断所导致的肠道细胞损伤。在门静脉和尾腔静脉之间形成端侧对端吻合(直径>2 cm)。每天观察犬是否有肝性脑病的迹象,并记录食物摄入量。每周记录体重。每月测量餐前血浆氨、血清尿素氮和葡萄糖浓度以及磺溴酞钠潴留情况。术后14至18周对犬实施安乐死并进行尸检。

结果

32只犬中有30只恢复且无并发症。血浆氨浓度升高、血清尿素氮和葡萄糖浓度降低、磺溴酞钠潴留时间延长(P<0.01)以及尸检检查均证实存在完全性门体分流。

结论

这种使门静脉血流暂时完全阻断的方法有助于准确建立对端门腔吻合,且该吻合在14至18周内保持通畅。

临床意义

当需要暂时阻断门静脉血流时,这种使门静脉血流暂时完全阻断的方法在临床手术中可能有用。

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