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CLINICAL AND EXPERIMENTAL STUDIES ON THE MAINTENANCE OF SUFFICIENT HEPATIC CIRCULATION WITH ARTERIAL BLOOD DURING THE TEMPORARY OCCLUSION OF THE HILAR HEPATIC CIRCULATION.

暂时阻塞肝门肝循环期间用动脉血维持充分肝循环的临床和实验研究。

基本信息

批准号：
63570638
负责人：
HAMAZAKI Keisuke
金额：
$ 1.34万
依托单位：
Okayama University
依托单位国家：
日本
项目类别：
Grant-in-Aid for General Scientific Research (C)
财政年份：
1988
资助国家：
日本
起止时间：
1988 至 1990
项目状态：
已结题

项目摘要

1.Experimental study in mongrel dogs: This study was performed to clarify the safe range of the blood flow volume to maintain the liver function, structure and systemic circulation as possible as normal under the condition of total hilar clamping when the hepatic circulation was supplied only through the extracorporeal catheter bypass from the artery to the hepatic portal vein in flow control.(1)In the study of the energy metabolism of the liver during the bypass circulation, the lowest limit of the arterial blood inflow volume tl maintain the hepatic function was confirmed to be in the range between 10% to 25% of the normal total hepatic blood flow volume.(2)In the study of the morphology of the liver after the bypass circulation for 2 hours, the lowest limit of the arterial blood inflow volume to maintain the hepatic structure normal was confirmed to be in the range between 10% to 25% of the normal total hepatic blood flow volume.The highest limit of that was confirmed to be in the range between 50% to 75% of the normal total hepatic blood flow volume.(3)In the study of the systemic hemodynamics during the bypass circulation, the safe flow rate of bypass circulation ranged from 25% to 75% of the normal total hepatic blood flow volume.2.Clinical studyThis double catheter bypass method was devised to perform block resection of the hepatoduodenal ligament in cases of the carcinoma of the bile duct and head of the pancreas. In the study of 20 clinical cases, this method was confirmed to be safe from the view point of the systemic hemodynamic and liver function tests.

1.杂种犬实验研究：本研究旨在明确在全肝门阻断条件下，仅通过动脉至肝门静脉的体外导管旁路血流控制供应肝循环时，维持肝功能、结构和体循环尽可能正常的安全血流量范围。(1)In通过对旁路循环期间肝脏能量代谢的研究，证实维持肝功能的动脉血流入量TL的最低限度在正常肝总血流量的10%至25%之间。(2)In通过对转流2小时后肝脏形态学的研究，证实维持肝脏结构正常的动脉血流入量的最低限度为正常肝总血流量的10%~ 25%，最高限度为正常肝总血流量的50%~ 75%。(3)In体外循环时全身血流动力学的研究表明，体外循环的安全流量范围为正常肝血流量的25%~ 75%。2.临床研究设计了双导管体外循环方法，用于胆管癌和胰头癌的肝十二指肠韧带阻断切除术。经20例临床病例研究，从全身血流动力学和肝功能检查的角度证实了该方法的安全性。