Therapeutic Effect Of Celiac Plexus Block Combined With Ulinastatin On Residual Liver Inflammation After Partial Hepatectomy In Rats

Objective Residual liver damage caused by excessive inflammatory reaction after hepatectomy significantly affects the prognosis of patients.How to inhibit this inflammatory response is the key.In this study,prospective,randomized,and controlled trials were used to observe inflammation at various time points after partial hepatectomy in rats.Changes in the level of the medium,to explore the effects of different treatment regimens on the injury to the rat body caused by residual liver inflammation after partial hepatectomy in rats,so that when the patient with liver occupying the disease needs surgery Perioperative treatment medication provides a certain reference to reduce certain damage effects.Method 40 SD rats were selected and 1% chloral hydrate was selected to inject anesthetized rats by intraperitoneal injection at a dose of 5 ml/kg.According to the method established by Higgins and Anderson,according to the method of Lu Yi [9] and Tang Zhaohui [10],A classical rat PH model was established.According to different treatment options after partial hepatectomy in rats,rats were randomly divided into 4 groups: control group,celiac plexus block(NCPB),ulinastatin group(UTI),celiac plexus block.The combined ulinastatin group(NCPB+UTI)was recorded as group A,B,C,and D.Control group,celiac plexus block(NCPB),ulinastatin group(UTI),celiac plexus block combined with ulinastatin group(NCPB+UTI).4 groups were given 4ml/normal saline,normal saline,ulinastatin injection and ulinastatin injection before and 30 min after operation.The physiological saline dose used was: 4 ml/kg;the dose of ulinastatin used was: 50000U/kg.The NCPB and NCPB+UTI groups received 0.5% lidocaine for celiac nerve block before PH,and the control group and UTI group were replaced with 0.9% saline.At 6h,12 h,and 24 h after operation,1 ml of venous blood was taken from each group to observe liver function ALT,AST and CRP,inflammatory factor activities(IL1-β and TNF-α);liver tissues harvested from rats at the end of the experiment.The liver tissue was observed by HE staining to observe the structural changes.All data were statistically analyzed using SPSS 22.0software,and P < 0.05 was considered statistically significant.Results 1.Results of serum liver function test in each group:(1)Compared with group A,the levels of ALT and AST in group B,group C and group D were significantly lower,ie ulinastatin or celiac plexus tissue,The combination of the two can reduce the levels of ALT and AST,the difference is statistically significant(p<0.05);compared with the D group,the levels of ALT and AST in group B and C are significantly increased,and the difference is statistically significant.The significance of the study(p <0.05),that is,the combination of the two methods is better than the single use of celiac plexus block or single use of ulinastatin.(2)Compared with group A,the CRP levels in group B,group C and group D were significantly lower,and the difference was statistically significant(p<0.05).Compared with group D,the levels of CRP in groups B and C were significantly higher.The difference was statistically significant(p<0.05),ie the combination of the two methods was superior to the single use of celiac plexus block or single use of ulinastatin.2.Results of serum inflammatory factors in rats in each group: Compared with group A,the levels of TNF-ɑ and IL1-β in group B,group C and group D were significantly lower,indicating celiac plexus block and/or pudding.The statin was statistically significant(p<0.05).Compared with the D group,the levels of TNF-ɑand IL1-β in group B and C were significantly increased,and the difference was statistically significant(p<0.05).That is,the combined effect of the two methods on reducing the levels of TNF-ɑ and IL1-β is superior to the two separate applications.(3)Pathological results: A group of rats with liver tissue showed severe histopathological damage,and the normal tissue structure of some hepatic lobules disappeared.The damage to the original structure was serious,the boundary was unclear,and the fibrous tissue proliferated.There are liver tissue randomly separated to form false leaflets of different sizes;under the microscope,the cells are swollen,the cytoplasm is turbid,the inflammatory cells infiltrate in the portal area,the hepatic sinusoids are dilated,and the hepatocytes are spotted necrotic;Group B,C The liver tissue of rats in group and group D was relatively light,and the overall condition was acceptable.The lobular boundary was obvious.The hepatic cord lesions were light and arranged neatly.Hepatocytes still showed edema,but they were significantly less than group A.Inflammatory Cell infiltration exists,but to a lesser extent.That is to say,compared with the control group,the liver tissue damage in the treatment group was significantly reduced,and the liver tissue of the combination treatment group of the two regimens was closer to the normal liver tissue.Conclusion 1.Simple celiac plexus block or ulinastatin can alleviate liver function damage after partial hepatectomy in rats.2.Celiac plexus block combined with ulinastatin can reduce the inflammatory response after partial hepatectomy in rats,and the effect is better than single factor treatment.