Effect of bypass flow rate of portosystemic bypass on the visceral organs in acute portal vein occlusion

门体绕道流量对急性门静脉闭塞内脏器官的影响

• 批准号: 61570657
• 负责人: KASAHARA Kogorou
• 金额: $ 1.28万
• 依托单位: Jichi Medical School
• 依托单位国家: 日本
• 项目类别: Grant-in-Aid for General Scientific Research (C)
• 财政年份: 1986
• 资助国家: 日本
• 起止时间: 1986 至 1987
• 项目状态: 已结题
• 来源: https://kaken.nii.ac.jp/grant/KAKENHI-PROJECT-61570657/
• 关键词: Acute portal vein occlusion; portosystemic bypass; anti thrombogenic catheter; バイパス流量

The object of this study was to determine the critical flow rate (BFR) of the portosystemic bypass, using heparin coated catheter Anthrone, during acute portal vein occlusion (PVO). BFR was controlled at 10% (Group 1) , 30% (Group 2), 50% (Group 3) of the portal flow in the individual experimental groups of anesthetized dogs. Hemodynamic and biochemical changes were observed during 2 hours in each group.With decreased BFR, portal venous pressure (P_<pv>) increased, with 47.1 mmHg in Group 1 and 26.8 mmHg in Group 2, and superior mesenteric arterial flow (F_<sma>) decreased remarkably in both Group 1 and Group 2. However, P_<sma> showed negligible changes in Group 3. Thus, negative correlation between BFR and P_<pv> (r=-0.911, P<0.0001), and positive correlation between BFR and F_<sma> (r=0.875, P<0.0001) were found respectively. With decreased BFR, portal venous blood hematocrit increased, with 54.5% in Group 1 and 50.3% in Group 2. Following 2 hours PVO, pH levels of portal venous blood were reduced, with 7.210 in Group 1 and 7.337 in Group 2. CPK-BB levels of portal venous blood correlated well to the degree of intestinal insultation.In conclusions, the critical BFR must be between 10% and 30% of portal flow for life sustaining up to 2 hours PVO, and 50% BFR is sufficient enough in more than 2 hours PVO, in the aspect of mesenteric organ insultation.

本研究的目的是确定急性门静脉闭塞（PVO）期间使用肝素涂层导管Anthrone行门体分流术的临界流速（BFR）。将麻醉犬的BFR分别控制在门静脉血流量的10%（第1组）、30%（第2组）、50%（第3组）。观察各组2 h内血流动力学和生化指标的变化，随着BFR的降低，门静脉压力（P<pv>）升高，组1和组2分别为47.1mmHg和26.8mmHg，肠系膜上级动脉血流量（F<sma>）均显著降低。然而，<sma>在组3中，P_显示可忽略的变化。BFR与P_<pv>（r=-0.911，P&lt;0.0001）呈负相关，与F_<sma>（r=0.875，P&lt;0.0001）呈正相关。随着BFR降低，门静脉血红细胞压积升高，第1组为54.5%，第2组为50.3%。PVO 2小时后，门静脉血pH值降低，第1组为7.210，第2组为7.337。门静脉血CPK-BB水平与肠功能受损程度密切相关，提示门静脉阻塞2 h内维持生命的临界血流量应在门静脉血流量的10%~ 30%之间，而门静脉阻塞2 h以上时，血流量为50%就足够了。

项目成果

福本孝: 日本外科学会雑誌.

福本隆：日本外科学会杂志。

Takashi FUKUMOTO, Kogorou KASAHARA: "Effect of bypass flow rate of portosystemic bypass on the visceral organs in acute portal vein occulusion." Japanese Journal of Surgery.

Takashi FUKUMOTO、Kogorou KASAHARA：“急性门静脉闭塞时门体旁路的旁路流量对内脏器官的影响”。