【作者】 王琪；

【导师】 戈小虎；

【作者基本信息】 石河子大学 ， 外科学， 2014， 硕士

【摘要】 目的：初步探讨幼龄大鼠肝前型门静脉高压（Prehepatic Portal Hypertension，PPH）的模型，造模后左肾上腺静脉直径增粗，门静脉压力（Portal Pressure，PP）与左肾上腺静脉直径没有相关性。结扎左肾上腺静脉后不会影响肾功能及其肾上腺功能。为PPH患儿的诊断和术式的选择，初步提供了理论依据。方法：将80只幼龄Wistar大鼠（雌雄各半），随机分成4组：假手术组（Sham Operation，SO组）、部分门静脉缩窄组（Partial Portal Vein Ligation，PPVL组）、左肾上腺静脉结扎组（LeftRenal Vein Ligation，LRVL组）、部分门静脉缩窄联合左肾上腺静脉结扎组(PPVL+LRVL组)。采用部分门静脉结扎(PPVL)法[1-2]和（或）结扎左肾上腺静脉（LRVL）法[3-4]来复制PPH的模型。术后6w行体重、门静脉测压、门静脉造影、病理学检查等，并观察侧枝循环形成的情况；左肾上静脉直径的变化；左肾上腺静脉结扎后对肾功及肾上腺功能的影响。结果：1．术后6wSO组未形成门静脉高压，门静脉造影未形成侧枝循环。三组模型组PP均增高，其中PPVL、PPVL+LRVL组门静脉造影肝门区可见向肝性侧枝循环。2．PPVL组术后6w与SO组相比，PP升高（15.05±1.55cmH2O）（p<0.05）及左肾上腺静脉直径增粗（0.21±0.02mm）（p<0.05）。3．三组模型组的肾功能（Scr、BUN）及肾上腺功能（ALD、COR、ACTH）与SO组相比无差异（p>0.05）。结论：1．PPH的幼龄大鼠左肾上腺静脉均增粗，提供了经左肾上腺静脉行门体分流术的条件。2．左肾上腺静脉结扎后不会影响肾和肾上腺功能，且左肾和左肾上腺病理未见明显变化。3．左肾上腺静脉是一条重要的侧枝循环。4．左肾上腺静脉直径与PP没有相关性。更多还原

【Abstract】 Object: Preliminarily to discuss the prehepatic portal hypertension(PPH) of young rat in model,afterhad copied model the diameter of the left adrenal had enlarged, the portal pressure (PP) with left ardentvein no correlation.No effect renal function and adrenal function by ligation the left adrenal vein.To provedtheory pursuant of diagnosis and choiced surgical method with PPH childrenMethod: Eighty male young Wistar (male40and female40) rats were divided into four groups: ShamOperation groups(SO,n=20), Partial Portal Vein Ligation groups(PPVL,n=20), Left Renal Vein Ligationgroup(LRVL,n=20), Partial Portal Vein Ligation combine Left Renal Vein Ligation group (PPVL+LRVL,n=20).By partial ligation of the portal vein and(or) ligation left adrenal vein to builded model ofPPH.At postoperative (postop) six weeks to measured the portal pressure, portal phlebography, pathologyet al and observated portal, around the formation of collateral circulation, changed on diameter of the leftrenal vein, effects on renal and adrenal function after ligation of the left adrenal vein.Results:1.SO group was not formed portal hypertension and portal venography of collateralcirculation at postoperative six weeks, Which PPVL, PPVL+LRVL group portal phlebography of hepatichilum has visibled collateral circulation of intrahepatic.2.PPVL group had compared with the SO group at postoperative six weeks, the portal pressure hadincreased (15.05±1.55cmH2O)(p <0.05),the left adrenal vein diameter (0.21±0.02mm)(p <0.05) hadenlarged.3.Renal function (Scr, BUN) and adrenal function（ALD, COR, ACTH）of the three model groupspresented no difference compared with the control group（p>0.05）.Conclusion:1.The diameter of the left renal vein had enlarged of young Wistar of PPVL group,provided conditions of through the left adrenal vein to portosystemic shunt.2.There was no effect on renal function and adrenal function after the ligation of left adrenal vein. Noobvious pathological changed with kidney and adrenal gland.3.Left adrenal vein is an important collateral circulation.4.The portal pressure (PP) with left ardent vein no correlation.更多还原