联合肝脏分割和门静脉结扎二步肝切除术大鼠模型的建立

发布时间：2018-03-01 09:03

本文关键词： 肝切除术肝再生模型动物大鼠　出处：《中国普通外科杂志》2017年01期 　论文类型：期刊论文

【摘要】：目的:建立联合肝脏分割和门静脉结扎(PVL)二步肝切除术(ALPPS)大鼠模型。方法:将健康60只SD雄性大鼠随机均分为PVL组、ALPPS组、假手术组。PVL组行肝左外叶、左中叶、右叶门静脉分支结扎及尾状叶切除,保留肝右中叶分支;ALPPS组在PVL组手术的基础上,将肝左中叶与右中叶在缺血带处离断;假手术组仅游离出门静脉各分支,不结扎。检测大鼠术后肝再生率(HRR)、肝功能情况,以及肝左中叶病理损伤程度与肝右中叶Ki-67的表达。结果:与假手术组比较,ALPPS组、PVL组术后各时间点肝右中叶HRR均明显升高(均P0.05),且第4、7天ALPPS组肝右中叶HRR明显高于PVL组(155.96%vs.118.15%;174.86%vs.133.55%,均P0.05)。PVL组术后早期肝功能指标好于ALPPS组(均P0.05),但后期无统计学差异(均P0.05)。组织病理学检查显示,ALPPS组术后第1天肝左中叶坏死明显多于PVL组;ALPPS组肝右中叶Ki-67表达第2、4天明显高于PVL组(85.36%vs.61.84%;43.40%vs.29.06%,均P0.05)。结论:ALPPS与PVL均能促进肝再生,并且ALPPS比PVL能更快的促进肝再生;成功建立大鼠ALPPS模型,为研究ALPPS肝再生机制及相关并发症奠定了基础。
[Abstract]:Objective: to establish a rat model of combined liver segmentation and portal vein ligation (PVL) two-step hepatectomy. Methods: sixty healthy male SD rats were randomly divided into two groups: PVL group, sham operation group, left lateral lobe and left middle lobe. Right lobe portal vein ligation and caudate lobectomy. The left middle lobe and right middle lobe of the liver were cut off in the ischemic zone on the basis of PVL operation in the right middle lobe branch group, while in the sham operation group, the portal vein branches were only dissociated. Without ligation, the liver regeneration rate and liver function were measured. Results: compared with sham-operated group, the HRR of right middle lobe of liver in ALPPS group was significantly higher than that in ALPPS group at 4 ~ 7 days after operation (all P0.05%), and the HRR in right middle lobe of liver in ALPPS group was significantly higher than that in ALPPS group at 4 ~ 7 days after operation (all P0.05%), and the expression of HRR in right middle lobe of liver in ALPPS group was significantly higher than that in ALPPS group at 4 ~ 7 days after operation. The liver function in the PVL group was better than that in the ALPPS group (P 0.05), but there was no significant difference in the later stage (all P 0.05). Histopathological examination showed that the necrosis of the left middle lobe in the PVL group was significantly higher than that in the PVL group on the first day after operation (P 0.05), but there was no significant difference in the later stage (all P 0.05). The histopathological examination showed that the necrosis of the left middle lobe of the liver in the PVL group was significantly higher than that of the Ki-67 table in the right middle lobe of the liver in the PVL group. It was significantly higher than that of PVL group (85.36 vs.61.84v. 43.40 vs 29.06) on the 2nd day. Conclusion both PVL and WALPPS can promote liver regeneration. ALPPS can promote liver regeneration faster than PVL, and successfully establish rat ALPPS model, which lays a foundation for studying the mechanism of ALPPS liver regeneration and related complications.
【作者单位】：安徽医科大学无锡临床学院肝胆外科;中国人民解放军第一0一医院肝胆外科;
【基金】：南京军区医学科技创新课题重点基金资助项目(14D05)
【分类号】：R657.3;R-332

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