【摘要】 目的阐明扩大肝切除术后门静脉减压术和FK5 0 6的有效性。方法将实验猪随机分成 4组 ,每组 10头。A组为切除 80 %肝脏加门静脉腔静脉分流术加术前FK5 0 6处理 ,B组为切除80 %肝脏加门静脉腔静脉分流术 ,C组为切除 80 %肝脏加FK5 0 6 ,D组为对照组 (仅切除 80 %肝脏 )。观察血流动力学、肝功能和剩余肝组织微循环变化。结果A组和B组的 5d生存率分别为 80 %和6 0 % ,C组和D组为 30 %和 2 0 % (P <0 0 5 )。术后PVP≤ 2 0 0mmH2 O时生存率为 90 % (17/19) ,PVP >2 0 0mmH2 O时生存率为 10 % (P <0 0 1)。肝切除后 12h时A组和B组ALT低于C组和D组 (P <0 0 1)。术后 1d时A组剩余肝组织的微循环最好 (P <0 0 5 )。结论猪 80 %肝切除加门静脉腔静脉分流及FK5 0 6预处理能提高术后生存和促进剩余肝组织再生 ,PVP可作为判断扩大肝切除术预后的一个较好的指标。更多还原

【Abstract】 ObjectiveTo elucidate the effect of portal decompression and FK506 (FK) pretreatment on porcine extended hepatectomy.MethodsForty pigs were equally devided into 4 groups. Group A underwent 80% hepatectomy and portacaval shunt with FK pretreatment, group B did 80% hepatectomy and portacaval shunt, group C did 80% hepatectomy and FK pretreatment and group D did 80% hepatectomy. ResultsThe 5 day survival rate in Group A and B was 80% and 60% respectively, higher than 30% in Group C and 20% in group D ( P <0 05). The survival rate was 90% when PVP≤200 mm H 2 O , and 10% when PVP>200 mm H 2 O ( P <0 01) 12 hours after operation. The ALT level in Group A and B was significantly lower than that in group C and D 12 hours postoperatively ( P <0 01). The residual microcirculation was the best ( P <0 05) in Group A. ConclusionsExtended hepatectomy (80%) plus side to side portacaval shunt with FK pretreatment improve hepatic regenerative response and prolong postoperative survival in pigs.更多还原