Experimental study of the protective effect of intermittent hepatic pedicle clamping in the rat
Experimental study of the protective effect of intermittent hepatic pedicle clamping in the rat
复制标题
间歇性肝蒂夹闭对大鼠保护作用的实验研究
DOI：
10.1002/bjs.1800790409
复制
发表时间：
1992
影响因子：
9.6
通讯作者：
H. Bismuth
中科院分区：
文献类型：
--
作者：
H. Isozaki;R. Adam;M. Gigou;A. Székely;M. Shen;H. Bismuth
间歇性夹闭肝蒂期间肝脏对缺血的耐受性与连续Pringle操作期间的耐受性进行了比较。三组大鼠进行总的持续时间为60，90和120分钟的夹紧进行了研究。临时围手术期门腔静脉分流术用于排除内脏静脉淤滞的影响，并允许独立研究肝缺血的影响。在每组中，评价了三种门静脉夹闭方法：连续Pringle操作（n = 10）、30 min间歇性夹闭（n = 10）和15 min间歇性夹闭（n = 10）。肝脏缺血期之间的钳夹释放时间为5 min。记录第7天的存活率和术后肝功能变化（转氨酶、胆红素、溴磺酞清除、肝腺苷5′-三磷酸水平）。椎弓根间断夹紧的耐受性明显优于连续夹紧。这种方法优化了肝脏耐受长时间缺血的能力。对于一个给定的缺血持续时间，没有额外的改善，可以通过缩短间歇夹紧时间从30到15分钟。这些数据表明，当使用普林格尔操作，它应该是间歇性的，而不是连续的。
The tolerance of the liver to ischaemia during intermittent clamping of the hepatic pedicle was compared with that during a continuous Pringle manoeuvre. Three groups of rats undergoing total durations of clamping of 60, 90 and 120 min were studied. A temporary peroperative portacaval shunt was used to exclude the efects of splanchnic venous stasis and allow independent study of the efects of hepatic ischaemia. In each group, three methods of portal clamping were evaluated: a continuous Pringle manoeuvre (n = 10), a 30‐min intermittent clamping (n = 10) and a 15‐min intermittent clamping (n = 10). The clamp release time between the periods of liver ischaemia was 5 min. Survival at day 7 and postoperative changes in liver function (transaminase enzymes, bilirubin, bromsulphthalein elimination, liver adenosine 5′‐triphosphate levels) were recorded. Intermittent clamping of the pedicle was tolerated significantly better than continuous clamping. This method optimizes the ability of the liver to tolerate extended periods of ischaemia. For a given duration of ischaemia, no additional improvement could be produced by shortening the intermittent clamping period from 30 to 15 min. These data suggest that, when the Pringle manoeuvre is used, it should be applied intermittently rather than continuously.