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《门脉高压论文：胃去门静脉循环断流术对肝前型门静脉高压犬胃粘膜及微循环血管超微结构的影响》由会员上传分享，免费在线阅读，更多相关内容在学术论文-天天文库。
1、门脉高压论文：胃去门静脉循环断流术对肝前型门静脉高压犬胃粘膜及微循环血管超微结构的影响【中文摘要】观察胃去门静脉循环断流术对肝前型门静脉高压犬胃粘膜及粘膜下微循环血管超微结构的影响。方法12只成年杂种犬按照“李宗芳法”(门静脉缩窄一半,丝线引起门静脉慢性血栓形成)制作犬肝前型门静脉高压食管静脉曲张模型,并于建模后4周,造影检查侧支循环及曲张静脉形成情况。成模后随机分为2组,分别行贲门周围血管离断术(pericardialdevascularization,PCDV)和胃去门静脉循环断流术(de-splanchn
2、iccirculationofstomach,DSCS),分别于开腹后、手术后即刻及术后4周末测量门静脉及食管曲张静脉压力。手术前、手术后4周末测定肝功能指标。术后4周末取胃组织进行透射电镜观察。结果1.DSCS组门静脉压力由术前的23.64±0.40cmH2O降至术后4周的20.62±0.97cmH2O,差异有统计学意义(P<0.01)；食管曲张静脉压力由术前的22.14±0.93cmH2O降至术后4周的17.84±0.36cmH2O,差异有统计学意义(P<0.01)。2.手术前、后两组肝功能指标无明显变化(
3、P>0.05)。3.超微结构显示贲门周围血管离断术组胃粘膜上皮细胞微绒毛断裂、脱落,微绒毛明显减少,粘膜下微静脉内皮细胞基膜厚薄不均且不连续,内皮细胞间隙可见明显红细胞聚集。而DSCS组胃粘膜上皮细胞微绒毛排列较整齐,断裂少见,粘膜下微静脉内皮细胞未见明显异常。结论DSCS手术可降低肝前型门静脉高压犬的门静脉及食管曲张静脉压力,同时能改善胃粘膜及粘膜下微循环血管超微结构。【英文摘要】Toevaluatetheinfluenceofde-splanchniccirculationofstomach(DSCS)on
4、ultramicrostructureofgastricmucosaandsubmucosalmicrocirculationinprehepaticportalhypertensivecaninemodels.MethodsWeestablishedprehepaticportalhypertensivecaninemodelsbyhalfconstrictionandsilklinechronicembolizationofportalvein.Theesophagealvaricesandcollater
5、alcirculationwereobservedbyvenographyafter4weeksofmodeling.Theformedcaninemodelsweredividedintopericardialdevascularization(PCDV)group(PCDV)andDSCSgrouprandomly.Wemeasuredtheportalvenouspressure(PVP)andesophagealvaricealpressure(EVP)respectivelybypuncturings
6、uperiormesentericveinandpericardialvaricesbeforesurgery,immediatelyaftersurgeryand4weeksaftersurgery.Wealsotestedtheliverfunctionpreoperativelyand4weeksaftersurgery.Theultrastructurewasobservedbytransmissionelectronmicroscopy4weekspostoperatively.Results1.Th
7、ePVPwasdecreasedsignificantlyfrom23.64±0.40cmH2Oto20.62±0.97cmH2OafterDSCS(P<0.01).TheEVPwasdecreasedsignificantlyfrom22.14±0.93cmH2Oto17.84±0.36cmH2OafterDSCS(P<0.01).2.Therewasnoobviousdifferentchangesintheliverfunctionpreoperativelyandpostoperatively(P>0.
8、05).3.ThegastricmucosallesionsinDSCSgroupwerelighterthanthatinPCDVgroup4weeksaftersurgery.Ultrastructureshowedthatthemicrovillusofgastricepitheliumcellswereinterruptedandfelloffandthatmicrovillu
