胃去门静脉循环断流术犬模型的建立.docVIP

胃去门静脉循环断流术犬模型的建立 作者：赵磊 周岩冰 李世宽 吕亮 李宇 王亮 于冠君 【摘要】 目的 设计胃去门静脉循环断流术的方法，并建立胃去门静脉循环断流术犬模型。方法 应用缩窄门静脉主干1/2加丝线慢性栓塞术制作犬肝前型门静脉高压食管静脉曲张模型。然后，实施胃去门静脉循环断流术，即行脾切除后，保留贲门周围血管、食管曲张静脉及迷走神经，从根部离断胃冠状静脉等汇入门静脉系统的胃静脉血管，使胃的静脉血流经门奇间的交通支血管进入体循环。将已形成肝前型门静脉高压食管静脉曲张犬12只随机分为脾切除组、贲门周围血管离断术组、胃去门静脉循环断流术组。于开腹后、手术后即刻及术后3周末测量门静脉及食管曲张静脉压力。术前及术后3周末测定肝功能指标。结果 犬模型均存活。手术后即刻及术后3周末与开腹后相比，胃去门静脉循环断流术组门静脉压力显著下降(F=7.386，q=3.503、3.121，Plt;0.05);食管曲张静脉压力亦显著下降(F=8.026，q=3.661、3.240，Plt;0.05)。手术前后肝功能指标变化不明显(t=0.268～1.325，Pgt;0.05)。结论 胃去门静脉循环断流术犬模型存活率高，制作方法简单易行，模型质量可靠，有助于研究胃去门静脉循环断流术对门静脉血流动力学参数的影响。 【关键词】 高血压,门静脉;模型,动物;狗 [ABSTRACT] Objective To design a method of deportalcirculation disconnection (DPCD) of stomach and create a model of DPCD of stomach in dog. Methods A model of prehepatic portal hypertension with esophageal varices (VE) was created in dog through narrowing main portal vein by plus suture silk to establish chronic embolism. Disconnection of DPCD was then performed, i.e. splenectomy with preserving peripheral vessels of the cardia, varicose veins of the esophagus and vagus nerve. The vena coronaria ventriculi and others that abouchement in portal system were mutilated at their base, resulting in blood stream of the stomach flowed into general circulation through the communicating branches. The 12 dog models created were randomized to three groups as group A (splenectomy),group B (mutilation of blood vessel surrounding the cardia), and group C (DPCD of the stomach). The portal vein pressure (PVP) and varicose vein pressure (VVP) was measured at opening of the abdomen, immediately after surgery, and three weeks postoperatively. Liver function tests were conducted before and three weeks after surgery. Results All the model dogs survived. Compared with immediately after surgery and three weeks later to at opening of the abdomen, the PVP and VVP decreased significantly after DPCD (F=7.386;q=3.503,3.121;Plt;0.05) and (F=8.026;q=3.661,3.240;Plt;0.05), respectively. As for li