Thiel H
Fortschr Med. 1977 Jul 21;95(27):1741-4.
Hepatic and systemic hemodynamics were studied in the rat under different experimental conditions. It could be demonstrated that the hepatic arterial blood flow in normal as well as in sick liver of animals is well regulated: for example by means of the venovasomotorical reaction (portoarterial interaction) and systemically by autoregulation. There exists an inverse correlation between arterial and portalvenous liver blood flow: As portal liver blood flow decreases hepatic arterial flow increases. Especially a marked increase of hepatic artery flow was found after portocaval end-to-side anastomosis. Yet, the hepatic artery flow improvement after portocaval shunt could not compensate the diverted portalvenous blood supply at all. In states of portal hypertension with a relevant portocaval collateral circulation, also after surgical portocaval shunt, the systemic circulation becomes more hyperdynamic. There also exists a remarkable relation between the extent of portocaval shunt flow to circulating blood volume, cardiac output and circulation time. Some correlates of the experimental findings with the altered hemodynamics in human liver cirrhosis were found and discussed from the viewpoint of portocaval shunt surgery in man.
在不同实验条件下对大鼠的肝脏和全身血流动力学进行了研究。结果表明,正常动物以及患病动物肝脏的肝动脉血流均受到良好调节:例如通过静脉血管运动反应(门静脉与动脉的相互作用)以及全身的自动调节。肝动脉血流与门静脉血流之间存在负相关:随着门静脉血流减少,肝动脉血流增加。特别是在门腔静脉端侧吻合术后,发现肝动脉血流显著增加。然而,门腔分流术后肝动脉血流的改善根本无法补偿被分流的门静脉血液供应。在存在显著门腔侧支循环的门静脉高压状态下,即使在手术门腔分流术后,全身循环也会变得更加高动力。门腔分流流量与循环血容量、心输出量和循环时间之间也存在显著关系。从人类门腔分流手术的角度出发,研究并讨论了一些实验结果与人类肝硬化血流动力学改变之间的相关性。