The Experiment Research Of Portal Veinblood Flowmechanics And Blood Biochemical Supersession Indexchange After Performing Distal Splenic Vein Hepatic Artery Shunt

Objective:Choose the healthy small-scale pigs of BaMa of Guangxi,walk and carry the distal splenic vein hepatic artery shunt,observe postoperative stomach spleen district intravenous blood shunt into route pressure change to enter liver, and measure this skill type impact on pig's liver of experiment and every biochemical supersession index of this operation.For this skill type further research among hyperbarism animal's model of portal vein of liver cirrhosis with applying to offering the experiment foundation and scientific basis clinically.Method:1,Choose 15 healthy small-scale pigs,general anesthesia tests pigs, chases layer and enters the abdominal cavity,measure normal liver and spleen size,gather the vena cava and main arterial blood of belly,measure liver function,electrolyte,blood coagulation function,blood ammonia and analysis of artery vim and vigour at this moment,cut and fetch some liver,organize the regular pathology of the conduct check.2,Through spleen being intravenous and portal vein backbone route differentiate installation examine,keep device, measure normal portal vein pressure.3,Carry spleen to be intravenous to carry competent end identical,wait for spleen venous pressure rise to open blood vessel block after the terminal high value far with liver total artery far,change in the observation spleen venous pressure of different time points,pour into right amount of methylene blue solutions,observe the liver and dye the situation.4, ??Raise the experimental pig while being postoperative,smoke the intravenous blood at postoperative 3 days,one week and 2 weeks separately,obtain the same index again.5,Put the experimental pig to death in postoperative 4 weeks, collect the blood of vena cava and measure the same index before putting to death;Cut and fetch some liver,organize the regular pathology of the conduct check;Measure the liver,spleen size and intravenous pressure of the spleen at this moment;Pour into the solution dyeing situation of observing the liver of right amount of methylene blue through the spleen vein.Result:1,The dissection characteristics of the portal vein,liver artery pipeline system outside experiment pork liverExperimental pig portal vein backbone intravenous and mesenterium vein converge by spleen,backbone long 3.31±0.07 cm,the wide foot-path is 9.40±0.25 mm,the portal vein is close to the liver essence to punish two main branches out and enter liver on the liver door.Spleen intravenous along pancreas rear conduct of walking,of the same name artery and it companion trip, mesenterium intravenous to remit the spleen vein to,remit it to one close to in the portal vein backbone.Liver total artery do,send out from abdominal cavity, send out stomach duodenum artery and right artery of stomach respectively on the way since,divided into 3 branches and entered liver immediately behind forming the inherent artery of liver.The wide foot-path of blood vessel disconnected end is 8.39±0.27 mm behind being intravenous to the disconnected spleen,the wide foot-path of disconnected end of blood vessel of total artery of liver is 4.70±0.32 mm.2.Different period experiment pig liver and change of spleen around the operationCarry on analysis of variance to pig's spleen data of the experiment of different periods,there is no statistics meaning(P＞0.05)in the difference。Prove to after the experiment pig performs a surgical operation,it is swelling that the spleen has no congestion,the identical mouth is unobstructed,without thrombosis,shunting the result can be maintained better.Experimental pig liver there is no obvious change with period in the above,can keep the normal size.3.The experimental pig's pressure of normal portal vein,and the change of backbone pressure of portal veinAfter opening the abdominal cavity,measure intravenous pressure of the experimental pig's normal spleen and portal vein backbone pressure strength,it is 20.5±0.74cmH2O and 19.2±0.66cmH2O respectively.Intravenous pressure of the spleen is higher than the backbone pressure of portal vein,a pressure is passed degree between the two,through not relatively having a statistics meaning.Portal vein backbone press than normal to drop slightly measure,in postoperative 4 week,18.9±0.75cmH2O,income all group data competent analysis of variance,difference have statistics meaning.Prove after setting up spleen intravenous-liver artery identical thorough fare,portal vein backbone press,reduce to some extent,but the significance change has not taken place.4.The intravenous blood of district of spleen of stomach shunts the pressure change that the route enters liver through the liver arteryMeasure intravenous pressure of the spleen in 5min,10min,15min,20min, 30min after the blood vessel is finished identically,find the venous pressure of spleen drops very fast within initial 15 minutes,it is 19.9±0.57cmH2O to 30min pressure,the pressure drops and prones to being steady,it is 19.7±0.84 cmH2O to measure the venous pressure of spleen in postoperative 4 weeks,with comparing normally and after the blood vessel is identical,the difference has no significance(P＞0.05),Prove the intravenous blood of district of spleen of postoperative stomach can enter the liver smoothly through the liver artery pipeline system,its optimum pressure value is 19.7±0.84cmH₂O.From broken liver carrying remnants pigeonhole normal far behind the artery,and 13.3±0.65cmH₂O,12.9±0.50cmH₂O,13.0±0.67 cmH₂O respectively in postoperative 4 weeks after the blood vessel is identical,it is 7.17±1.02 cmH₂O,6.94±0.74 cmH₂O,6.69±1.21 cmH₂Orespectively with the difference of spleen venous pressure of corresponding period,the difference does not have statistics meaning(P＞0.05),Prove stomach spleen district intravenous blood can shunt route optimum pressure difference to enter liver 14.3±1.04 cmH2O.In addition, inject right amount of methylene blue solutions into the spleen vein separately the above different periods,can see liver dyed,but abdominal cavity's other internal organs and blood vessel have not been seen and obviously dyed.5.Experimental pig's biochemical supersession index change of different periodsCollect the artery and intravenous blood normally and in postoperative 3 days,postoperative week,2 weeks and 4 weeks separately,measure liver function,electrolyte,blood coagulation function,ammonia density of blood and analysis of artery vim and vigour,find there are obvious changes while determining in postoperative week in most indexes,the difference has statistics meaning(P＜0.05),Resume gradually hereafter,to can recover to normal competence when being postoperative all around.6,Regular pathologic inspection result change of experimental pig's liverThe pathologic respect on the whole,the naked eye observes the experimental pig's liver in postoperative 4 weeks:The appearance volume has not increased or dwindled,the appearance has not changed,has not increased thick on the edge,the surface is smooth,not touching tubercle,the texture is soft, the tangent plane is reddish brown,it is basically identical to compare with normal liver before the skill.Regular HE dye mirror observe experiment pig hepatocyte shape basically normal meet postoperative 4 week,have not seen hepatocyte necrosis of any kind,only can see some water sample sex change of hepatocyte.Conclusion:1.Health Small-scale pigs(BaMa,Guangxi)competent to carry distal end splenic vein hepatic artery shunt,stomach spleen district intravenous blood can smooth via shunt route enter liver and keep steadily,this optimum pressure value and pressure difference are 19.7±0.84cmH2O and 14.3±1.04 cmH2O respectively.After shunting portal vein backbone press it changes prominent,liver door pulse blood flow is be better too keep.2.This operation skill type to health small-scale pig's liver function,electrolyte,blood coagulation function,blood ammonia,artery vim and vigour and influence that liver organize to pass,can receive effective recovery while being postoperative,influence,survive.3.This result of study treats the further research of function to hyperbarism animal's model of portal vein of liver cirrhosis and applies to offering abundant theoretical foundation and department clinically for this skill type Study the basis.