犬的肝昏迷模型手术造型方法

本文报告笔者采用保留下腔静脉的一期全肝切除术和门脉肝动脉分期结扎术制作犬的肝昏迷模型的情况、方法和结果。施行了保留下腔静脉全肝切除术12例,门脉肝动脉分期结扎术11例。行THEP时,在完成门腔静脉侧侧吻合后,游离、切断、结扎肝动脉、总胆管,然后结扎肝左外侧静脉,切除左侧叶,顺序如此法切除各肝叶。作PHL时则在完成门腔侧侧吻合后,结扎门脉近肝段后关腹。6～8周后再手术结扎犬动脉。THEP术后平均生存时间为11小时,犬在死亡前都有肝昏迷的临床表现。PHL术后都有慢性肝脑病的临床表现。用以上方法作成的模型可用于肝昏迷的病理生理学和肝昏迷治疗的研究。

CANINE MODEL OF HEPATIC COMA PRODUCED BY SURGICAL METHOD

ABSTRAC To create a model of hepatic coma; total hepatectomy with preservation of VENA CAVA inferior (THPVC) and ligation of portal vein and hepatic artery in different stages (PLPVHA). 12 dogs underwent THPVC. 11 dogs underwent PLPVHA. The steps of THPVC were: after side to side portocaval anastomosis The operator undertook to dissect, transect and ligate hepatic artery, choledochus and then left lateral hepatic vein. The left lateral lobe was removed, then the other lobes in succession in the same way.The steps of PLPVHA were: After completion of side to side portocaval anastomosis, the proximal hepatic segment of portal vein was ligated the abdomen was closed. The abdomen was reopened 6-8 weekslater and hepatic artery was ligated. The mean survival time was 11 hours in the group of THPVC. All dogs had manifestations of hepatic coma before death, The dogs developed chronic Hepatic encephalopathy After PLPVHA. It is a useful model to study the pathophysiology and treatment of hepatic coma.