激光多普勒血流法评价肝大切除后肝脏微循环的实验研究

S. D. Leonov, O. Khalepo, A. V. Rodin, A. S. Karasev, A. A. Sorokina, D. N. Panchenkov
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引用次数: 1

摘要

目的。目的:探讨肝大切除后微循环及其调控机制。材料和方法。取全麻下剖腹正中开腹术的Wistar大鼠10只,雌雄各重,体重180 ~ 270 g。采用俄罗斯LAKK-02型激光多普勒血流仪测定大鼠肝脏微循环。在右肝叶内脏表面放置微循环测定光导片;激光多普勒血流仪(Laser-Doppler flowmetry, ldl -gram)参数记录7 min后,依次在肝脏左外侧和正中叶结扎并切断;然后,大约70%的器官被切除。切除双肝叶后,在右肝叶内脏表面放置传感器,再次记录ldf图7分钟。观察肝大切除前后的基本微循环参数。肝扩大切除后,肝实质微循环平均算术参数下降11.71% (p < 0.05),微血管灌注减少。同时,微循环指标的标准差和变异系数变化无统计学意义。切除后神经源性振荡的中位最大振幅增加2.3个点(p < 0.05)。切除后肌源性振荡幅度也增加(p < 0.05);然而,增加的程度小于神经源性节律。结果发现,在70%的动物中,肝微循环内皮振荡的最大振幅在延长切除后增加;然而,一般情况下,内皮细胞在切除前后平均振荡的差异无统计学意义。在实验性肝切除术中,肝残端缺血发展的最可靠的LDF标准是平均算术微循环指数以及神经源性和肌源性振荡幅度。作者强调,这些指标的变化程度可能是肝残端切除后缺血严重程度的标志,可能具有预后价值,尽管所获得的结果需要进一步研究。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Assessment of the liver microcirculation by laserdoppler flowmetry after extended liver resection in the experiment
Purpose. To assess microcirculation and mechanisms of its regulation in the liver after its extended resection.Materials and methods. 10 Wistar rats of both sexes weighing 180–270 g which had median laparotomy under general anesthesia were taken in the trial. Microcirculation in the liver of rats was assessed with LAKK-02 Laser-Doppler flowmeter (Russia). A light guide for determining microcirculation was placed on the visceral surface of the right liver lobe; parameters of Laser-Doppler flowmetry (LDF-gram) were registered for 7 min. Then, ligatures were sequentially applied to the left lateral and median lobes of the liver followed by their cutting off; then, about 70 % of the organ were removed. After removal of both liver lobes, LDF-gram was recorded again for 7 minutes with a sensor placed on the visceral surface of the right liver lobe. Basic microcirculation parameters were registered before and after extended liver resection.Results. After the extended liver resection, average arithmetic parameters of microcirculation in the liver parenchyma decreased by 11.71 % (p < 0.05), which indicates the decrease in the microvasculature perfusion. At the same time, indicators of standard deviation of the microcirculation index and the coefficient of variation did not change statistically significantly. The median maximum amplitude of neurogenic oscillations after the resection increased by 2.3 points (p < 0.05). The amplitude of myogenic oscillations also increased after resection (p < 0.05); however, the degree of increase was less than that of the neurogenic rhythms. It was found that in 70 % of animals the maximum amplitude of endothelial oscillations increased in the liver microcirculation after the extended resection; however, in general, differences between the average endothelial oscillations before and after the resection were not statistically significant.Conclusion. In the experimental liver resection, the most informative and reliable LDF criteria on ischemia development in the liver stump were average arithmetic microcirculation indices as well as the amplitude of neurogenic and myogenic oscillations. The authors emphasize that the degree of changes in these indices may be a sign of ischemia severity in the liver stump after its resection and may have a prognostic value, although the results obtained require further research.
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期刊介绍: The main columns of "Chinese Journal of Laser Medicine & Surgery" include treatises, which report the latest research results in basic research and clinical trials in the field of laser medicine; comprehensive reviews of the latest research progress in laser medicine at home and abroad. In addition, there are short reports and excerpts from foreign journals, conference news and other columns. The journal has published a large number of papers on basic research on laser medicine and applied research in various clinical subjects, aiming to play a positive role in promoting the application of laser in medicine and improving the level of laser medicine research.
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