肝动脉和门静脉高位分支双重处理对犬肝脏结构和功能的影响.docVIP

肝动脉和门静脉高位分支双重处理对犬肝脏结构和功能的影响 作者：杨文军 作者单位：温州医学院第一附属医院 肝胆外科，浙江 温州 325000 【摘要】 目的 观察肝动脉和门静脉分支双重处理后犬肝脏结构和功能的改变。方法 杂种犬25只，随机分成假手术对照组和实验组，实验组进行肝动脉左支结扎和门静脉左支缩窄70%。分别于术后1，2，3，7和14 d处死动物，观察肝脏大体结构的变化，分别称取左右半肝脏的质量，检测肝脏功能，光学显微镜下观察肝脏显微结构改变，电镜下观察肝脏超微结构改变。结果 肝动脉左支结扎和门静脉左支缩窄70%后，左半肝脏呈进行性萎缩变小，右半肝脏则成比例地代偿性增生，在整个观察过程中，全肝的总质量维持恒定。肝脏功能在术后2~3 d时有轻度异常，很快即恢复正常。光镜下左半肝脏在早期出现少量的点、片状坏死，坏死周围出现大量的肝细胞凋亡，右半肝脏的肝小叶结构保持完整，术后肝细胞的增殖明显，有较多的分裂相存在。电镜下左半肝脏可见到典型的肝细胞凋亡，晚期呈明显纤维化改变。结论 肝动脉左支结扎和门静脉左支缩窄70%后，左半肝脏由于肝细胞大量凋亡呈进行性萎缩变小，右半肝脏则成比例地代偿性增生肥大，全肝的总质量和肝脏功能保持正常。 【关键词】 门静脉 肝动脉 凋 增殖 肝肿瘤 狗 Effects of double handling the branches of hepatic artery and portal vein on dogs liver structure and function YANG Wenjun， NI Haizhen， YU Zhengping， et al. Department of Genery Surgery， the First Affiliated Hospital of Wenzhou Medical College， Wenzhou 325000 Abstract Objective To study the effects of double handling the branches of hepatic artery and portal vein on dogs liver structure and function. Methods Twenty-five bastard dogs were randomly divided into control group and experiment group. The animals were killed on the 1st， 2nd， 3rd， 7th and 14th day， respectively. Liver morphologic structures were observed and liver lobes were weighed. To determine the contents of plasma ALT， the degree of hepatic regeneration and apoptosis were observed under light microscope. The ultrastructural changes of liver were observed under electron microscope. Results After double handling the branches of hepatic artery and portal vein， the left lobes were progressively atrophied， whereas the right lobes underwent compensatory regeneration， the total liver weight maintained at the level of sham-operated animals throughout the experiment. Plasma ALT levels increased mildly on the 2nd and 3rd days and recovered normal shortly. Dogs killed 1d after operation showed mild necrosis throughout the sections of left lobes; there were enormous apoptotic hepatocytes around necrosis. There was remarkable