【摘要】 目的在建立猪原位辅助性部分肝移植动物模型基础上,观察该手术对猪肝硬化门静脉高压症的初步治疗效果,为临床开展原位辅助性部分肝移植治疗肝硬化门静脉高压症提供理论及实验依据。方法采用结扎胆总管的方法复制猪胆汁性肝硬化动物模型,建模时间为8周,建模成功6只。另取健康良种幼猪6只作为供体组,参照有关文献进行麻醉、供体手术及供肝修整。术前、术后当天及第7天观察门静脉压力、血胆红素和肝功能,同时用彩色B超检查门静脉最大流速及流量。结果肝移植术后5只受体猪存活。术后第7天彩超观察存活猪两肝门静脉血流动力学情况,发现移植肝门静脉血流比宿主肝门静脉血流增多,移植肝功能良好,移植肝回流通畅。BIL、ALT及AST等指标明显好转,术后第7天开腹测量门静脉压力与术前相比显著降低;术前(20.76±2.43)cmH2O,术中关腹前(17.6±2.33)cmH2O,术后第7天(14.7±2.25)cmH2O。结论原位辅助性部分肝移植术能降低门静脉压力和提供一定肝功能支持,是一种较有希望的治疗肝硬化门静脉高压症的新方法。更多还原

【Abstract】 Objective To observe the efficacy of auxiliary partial orthotopic liver transplantation (APOLT) in treatment of portal hypertension of liver cirrhosis. Methods The pig model of biliary cirrhosis was established by ligation of choledoch. APOLT was performed according to the literature, portal vein pressure, blood bilirubin were observed during operation; hemodynamics and liver function were measured before, during and 7 days after operation by color ultrasonography or an autoanalyzer. Wedge biopsy specimens of each animal were obtained and examined. Results Five of 6 recipients were survived for 7days. One recipient died because of unsuccessful operation. Seven days after transplantation, ultrasonography showed the velocity of blood flow in the graft portal vein was higher than in native portal vein. The venous drainage of the graft was fluent and smooth. Serum levels of alanine aminotransferase, aspartate aminotransferase, bilirubin and total bilirubin were significant improved after operation. Portal pressure was (20.76±2.43) cmH2O, (17.6±2.33)cmH2O and (14.7±2.25)cmH2O before, during and 7 days after operation respectively (P<0.01). Conclusion Auxiliary partial orthotopic liver transplantation may provide an effective treatment for portal hypertension with improved liver function and decreased portal vein pressure.更多还原