Studies on pathophysiology after hepatectomy for dogs with obstructive jaudice under occlusion of hepatic blood inflow

梗阻性黄疸是由成年杂种犬胆囊切除术和结扎和切割远端胆总管引起的。观察梗阻性黄疸犬肝切除术后残肝缺血再灌注损伤及肝血流阻塞的病理生理。梗阻性黄疸犬在结扎总胆管和胆囊切除术后2周行40%肝切除术，阻断肝动脉和门静脉10分钟，残肝中过氧化脂含量显著升高，SOD活性降低，黄嘌呤氧化酶活性无变化。3小时后，大鼠外周血内毒素和β - nah水平明显升高，吞噬指数明显下降。7天存活率仅为23.1%，许多狗死于肝功能衰竭。自由基清除剂的作用：在缺血再流前给予辅酶Q_<10>(CoQ_<10>)或环氧丙烯-共顺丁烯酸超氧化物酶（SM-SOD），可明显阻止残肝上述现象的发生，7天存活率显著提高至76.9%和69.2%。无论给予CoQ_<10>或SM-SOD，肝血流再流后门静脉内毒素水平均显著升高。然而，这些药物明显降低了外周血中的水平。主动分流门静脉至下腔静脉的作用：主动分流门静脉至下腔静脉阻断肝血流10分钟后，门静脉及外周血内毒素水平均无变化，残肝损伤较轻。然而，当主动旁路封闭肝血流20分钟后，残肝中过氧化脂质含量明显升高，SOD活性降低，而门静脉和外周血中内毒素水平保持不变。3 h后外周血β - nah水平明显升高，吞噬指数明显下降。7天存活率仅为33.3%，许多狗死于肝功能衰竭。少

Obstructive jaundice was produced in adult mongrel dogs by cholecystectomy and ligation and cutting of the distal common bile duct. The pathophysiology of ischemia-reperfusion injury on remnant liver after hepatectomy and the occlusion of hepatic blood inflow was evaluated in dogs with obstructive jaundice.1.When 40% hepatectomy under 10-minute occlusion of both hepatic artery and portal vein was performed for dogs with obstructive jaundice at 2 weeks after ligation of the common bile duct and chole-cystectomy, the content of lipid peroxide increased significantly in the remnant liver with reduction of SOD activity, while xanthine oxidase activity did not change. The levels of endotoxin and beta-NAH in peripheral blood had significantly increased, and phagocytic index had markedly decreased after 3 hours. Survival rate at 7 days was only 23.1% and many dogs died of liver failure.2.Effects of free radical scavengers : When Coenzyme Q_<10>(CoQ_<10>) or stirene-co-maleic acid superoxide d … More ismutase(SM-SOD) was administered before ischemia and reflow, the development of the above phenomenon in the remnant liver was prevented significantly and the survival rate at 7days was improved remarkably to 76.9% and 69.2%. The endotoxin levels in the portal venous blood were increased significantly after reflow of the hepatic blood inflow, regardless of the administration of CoQ_<10> or SM-SOD.Whereas, the levels in the peripheral blood were markedly reduced by these drugs.3.Effects of active bypass of the portal vein to inferior vena cava : When the hepatic blood inflow was occluded for 10 minutes with active bypass of the portal vein to inferior vena cava, the levels of endotoxin in both the portal venous blood and the peripheral blood did not change, and the remnant liver injury was milder. However, when the hepatic blood inflow was occuluded for 20 minutes with active bypass, the content of lipid peroxide increased significantly in the remnant liver with reduction of SOD activity, while the levels of endotoxin in both the portal venous blood and the peripheral blood remained the same. The level beta-NAH in peripheral blood increased significantly and the phagocytic index decreased markedly after 3 hours. Survival rate at 7 days was only 33.3% and many dogs died of liver failure. Less