肝动脉结扎联合门静脉部分阻断对肝再生及肝细胞癌生长的影响

doi:10.3969/j.issn.1005-6483.2021.04.020

摘要/Abstract

摘要： 目的：观察结扎裸鼠患侧肝动脉并部分阻断患侧门静脉血流对保留侧肝脏再生及患侧肿瘤生长的影响。方法：取健康4周龄裸鼠，建立裸鼠肝细胞肝癌模型，120只随机分为4组：空白对照组30只(sham),患侧肝动脉结扎组30只(hepatic artery ligation,HAL),患侧部分门静脉阻断组30只(partial portal vein ligation,pPVL),患侧肝动脉结扎联合患侧部分门静脉阻断组30只(HAL+pPVL )。分别做相应处理后，在不同的时间点观察血清生化指标、保留肝脏再生率、肿瘤大小及肿瘤周围微血管侵犯(microvascular invasion，MVI)。结果：pPVL+HAL组死亡1只，在72小时内，pPVL组死亡1只，在术后24小时内。丙氨酸氨基转移酶（ALT）及门冬氨酸氨基转移酶（AST）浓度水平在术后24小时及72小时,pPVL组及HAL+pPVL组较Sham组高，差异有统计学意义(P<0.05)。在术后72小时,1周,2周以及3周,pPVL组及HAL+pPVL组保留侧肝脏质量与Sham及HAL组比较，差异有统计学意义(P<0.05)。〖JP2〗在术后1周，2周及3周，HAL组及pPVL+HAL组肿瘤体积与pPVL组及Sham组比较，差异有统计学意义(P<0.05)。将Sham组与pPVL组合并为对照组，HAL组与HAL+pPVL组合并为实验组，MVI阳性率在术后3周实验组与对照组比较，差异有统计学意义(P<0.05)，且实验组术后3周与术后2周比较差异有统计学意义(P<0.05)。结论：HAL+pPVL可促进保留侧肝脏代偿增生的同时在一定时间内可抑制肿瘤的生长。

关键词: 肝细胞肝癌, 肝动脉结扎, 门静脉部分阻断, 动物实验

Abstract: Objection：To observe the effect on naked mice，sliver hyperplasia and hepatocellular carcinoma growth after liver arterial ligation combined with partial portal ligation.Methods：To take healthy 4weekold naked mice,establish hepatocellular carcinoma models,divide 120 naked mice into 4 groups randomly:control group(Sham n=30);partial portal vein ligation group,(pPVL n=30),hepatic artery ligation group(HAL n=30)，HAL combined with pPVL group(HAL+pPVL n=30).After corresponding treatment, serum biochemical indexes, preserved liver regeneration rate, tumor size and surrounding microvascular invasion were observed at different time points.Result：One naked mouse dead in pPVL+HAL group in 72h,also one naked mouse in pPVL group dead in 24h.The ALT and AST levels of pPVL group and HAL+pPVL group was significantly different from that of Sham group at 24h and 72h after operation(P<0.05).The preserved side liver quality of PVL group and HAL+pPVL group was significantly different from that of Sham group and HAL group at 72h,1W,2W,3W after operation(P<0.05).The tumor volume of HAL group and HAL+pPVL group was significantly different from that of PVL group and Sham group at 1W,2W and 3W after operation(P<0.05).The Sham group and PVL group were combined as the control group,and the HAL group and HAL+pPVL group were combined as the experimental group,The positive rate of MVI in the experimental group was significantly different from the control group at 3W after operation(P<0.05),and also that was significant difference between 2W and 3W after operation in the experimental group(P<0.05).Conclusion：HAL+pPVL could promote the growth of preservated liver hyperplasia and inhibit the growth of tumor in a short period of time,which provides a new treatment for some patients with advanced hepatocellular carcinoma.

Key words: hepatocellular carcinoma, hepatic artery ligation, partial portal ligation, animal experiment

潘乐玉, 郭德良, 张玉仙等. 肝动脉结扎联合门静脉部分阻断对肝再生及肝细胞癌生长的影响[J]. 临床外科杂志, 2021, 29(4): 367-371.

参考文献

Metrics

Viewed

Full text

Abstract

Cited

Shared

Discussed

本文评价

推荐阅读 10

[1]	冯小仍;陈滨;余斌. 骨盆后环骨折内固定方式的稳定性探究[J]. 临床外科杂志, 2016, 24(5): 332 -0 .
[2]	李学荣;陈永平;秋实;等. 腰椎休门氏病伴脊柱侧弯畸形一例[J]. 临床外科杂志, 2017, 25(11): 880 .
[3]	冯锦腾范坤张广健付军科高蕊. 食管异物202例临床分析[J]. 临床外科杂志, 2018, 26(9): 683 -685 .
[4]	韩涛, 张树顺, 郭亚民. 脾切除联合脾片移植治疗Ⅲ～Ⅳ级脾破裂的疗效及对免疫功能和血栓形成风险的影响评估[J]. 临床外科杂志, 2018, 26(12): 943 -945 .
[5]	高宝山, 连鑫, 傅耀文等. 以嵌合体为基础的器官移植操控性免疫耐受的研究进展[J]. 临床外科杂志, 2018, 26(12): 976 -979 .
[6]	胡俊杰, 熊治国. 胃癌远端胃切除术后消化道重建手术方式选择的再思考[J]. 临床外科杂志, 2019, 27(5): 376 -378 .
[7]	唐云德, 徐卫国, 于风珍, 尚林强. 椎间孔镜微创技术治疗老年腰椎间盘突出症的临床分析[J]. 临床外科杂志, 2019, 27(5): 439 -442 .
[8]	邓青竹, 李新华. 经皮穴位电刺激对腹腔镜单侧肾切除术术后康复的影响[J]. 临床外科杂志, 2019, 27(6): 477 -479 .
[9]	汤汉心, 林喜容, 陈锦镜. 经外侧裂-岛叶入路显微手术治疗基底节区脑出血的临床效果及其对神经因子的影响[J]. 临床外科杂志, 2019, 27(10): 892 -894 .
[10]	屈日荣, 田义涛, 别磊, 张洋, 付向宁 . 心包内异位甲状腺一例[J]. 临床外科杂志, 2019, 27(11): 959 -960 .