| 摘要: |
| 目的 通过胆道对肝损伤模型灌注低温液体评估其诱导肝脏低温效果。方法 巴马小型猪14只，随机平均分为对照组和低温组。行气管插管全麻，开腹后对肝脏制创，出血15 min后采用补液+创口按压进行初期救治，1 h后缝合创口，对照组不做其他干预措施，低温组胆道灌注4℃乳酸林格液。记录动物血流动力学、体温和肝脏局部温度变化，并采血检测肝功能。结束后，切取动物肝脏组织做病理学研究。结果 实验过程中，对照组和低温组初期失血量、各检测时间点心率和平均动脉压差异均无统计学意义。干预2 h后，对照组和低温组肝温分别下降（1.36±0.80）℃和（2.72±1.01）℃，两组间差异有统计学意义（P=0.020）；体温分别下降（0.89±0.76）℃和（0.97±0.97）℃，差异无统计学意义（P=0.87）。灌注结束后低温组天冬氨酸转氨酶水平低于对照组（P<0.05），低温组炎性细胞浸润明显轻于对照组。结论 胆道灌注4℃乳酸林格液对肝脏有降温效果，并能促进肝功能恢复，减轻肝脏炎症反应，从而对创伤肝脏起到保护作用。 |
| 关键词: 胆道 灌注 低温治疗 肝损伤 |
| DOI：10.3724/SP.J.1008.2014.00520 |
| 投稿时间：2014-03-09修订日期：2014-04-28 |
| 基金项目: |
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| Efficacy of infusing cold fluid through the bile duct in cooling the liver |
| DOU Guang-jian,YU Yong,LIU Chen,TAN Wei-feng*,JIANG Xiao-qing* |
(Department of Biliary Tract Surgery(Ⅰ), Eastern Hepatobilary Surgery Hospital, Second Military Medical University, Shanghai 200438, China
*Corresponding authors.) |
| Abstract: |
| Objective To evaluate the liver cooling effect of infusing cold fluid through the bile duct in liver injury models. Methods A total of 14 BA-MA mini-pigs were randomized into two groups: control group (n=7) and hypothermia group (n=7). All the animals underwent tracheal intubation under general anaesthesia and liver injury was created after opening the abdomen. The liver bleeding was allowed for 15 min, and then initial treatment was given by packing the liver injury and infusing fluid for 1 hour before suturing the wound. Then the cold fluid (4℃ lactated Ringer's solution) was infused through the bile duct in the hypothermia group, with no further treatment given to the control group. The body and local liver temperature and hemodynamic variations were recorded. Blood samples were collected from the front vena cava to perform liver function tests. The liver specimens of animals were subjected to histopathological evaluation at the end of the experiment. Results The primary bleeding volume, heart rate and mean artery pressure at different time points were not significantly different between the two groups. After 2 hours intervention, the liver temperature dropped by(1.36±0.80)℃ in the control group and by (2.72±1.01)℃ in the hypothermia group, with significant difference found between the two groups(P=0.020); at the same time point, the body temperature dropped by(0.89±0.76)℃ and (0.97±0.97)℃, respectively; showing no significant difference between the two groups(P=0.87). Liver function examination showed that at the end of infusion aspartate transaminase (AST) in the hypothermia group was significantly lower than that in the control group (P<0.05). The inflammatory cell infiltration of liver tissues in the hypothermia group was slighter than that in the control group. Conclusion Infusion with cold 4℃ lactated Ringer's solution has a protective effect on liver trauma by inducing liver hypothermia to promote the recovery of liver function and alleviate liver inflammation reaction. |
| Key words: biliary tract infusion hypothermia therapy liver injury |
