• 1.山東省萊州市人民醫(yī)院普外科(萊州261400);;
  • 2.山東省萊州市鑫利醫(yī)院(萊州261400);

目的　采用手術(shù)方法結(jié)扎門靜脈分支，觀察對側(cè)肝臟的再生狀態(tài)。方法　健康Wistar雄性大鼠60只，隨機均分成結(jié)扎組和假結(jié)扎組，在乙醚麻醉下行門靜脈左支結(jié)扎和假結(jié)扎手術(shù)，分別在術(shù)后第1、2、3、7及14 d用乙醚麻醉動物，心臟采血檢測血清ALT值，取出肝臟后稱重量； 在光鏡下觀察肝組織的病理變化，并計數(shù)肝細胞核分裂指數(shù)； 采用免疫組化的方法計數(shù)增殖細胞核抗原（PCNA）指數(shù)； 在電鏡下觀察肝細胞超微結(jié)構(gòu)變化。結(jié)果?、傺錋LT值結(jié)扎組與假結(jié)扎組比較在術(shù)后第1 d升高（P＜0.01），但在第2 d開始恢復(fù)正常； ②肝臟重量兩組間差異無統(tǒng)計學(xué)意義（P＞0.05）； ③肝細胞核分裂指數(shù)結(jié)扎組與假結(jié)扎組比較，術(shù)后第1~3 d明顯升高，第2 d達高峰，第3 d有所下降，但仍高于假結(jié)扎組（P＜0.01），以后逐漸恢復(fù)正常； ④PCNA陽性細胞計數(shù)結(jié)扎組與假結(jié)扎組比較，術(shù)后第1~3 d明顯增多，第2 d達高峰，第3 d有所減少，但仍高于假結(jié)扎組（P＜0.01），以后逐漸恢復(fù)正常。結(jié)論?、俅笫箝T靜脈左支結(jié)扎后，引起未結(jié)扎側(cè)肝細胞的活躍再生，再生后的肝臟可恢復(fù)原來的重量; ②大鼠75%肝葉的門靜脈分支結(jié)扎不影響肝功能，是安全可行的; ③大鼠門靜脈分支結(jié)扎可以作為研究肝臟再生動物模型的方法。

引用本文： 郭美祥高麗華劉力波孟召華宮秀美. 大鼠門靜脈分支結(jié)扎后肝再生的實驗研究. 中國普外基礎(chǔ)與臨床雜志, 2006, 13(5): 550-554. doi: 復(fù)制

1. 　Tanaka H, Hirohashi K, Kubo S, et al. Preoperative portal vein embolization improves prognosis after right hepatectomy for hepatocellular carcinoma in patients with impaired hepatic function \[J\]. Br J Surg， 2000; 87(7)∶879.
2. 　葛敦鈞， 錢　峰. 肝癌預(yù)治療后二期切除時機的探討 \[J\]. 中華肝膽外科雜志， 1998; 5（5）∶331.
3. 　Shimamura T, Nakajima Y, Une Y, et al. Efficacy and safety of preoperative percutaneous transhepatic portal embolization with absolute ethanol: a clinical study \[J\]. Surgery， 1997; 121(2)∶135.
4. 　湯釗猷主編. 原發(fā)性肝癌研究與進展 \[M\]. 上海: 上海醫(yī)科大學(xué)出版社， 1990∶86~89.
5. 　陸　森， 錢建民， 黃海清， 等. 幾種不同預(yù)測大鼠肝臟體積（重量）方法的比較 \[J\]. 中華實驗外科雜志， 2002; 19（3）∶252.
6. 　Rocheleau B, Ethier C, Houle R, et al. Hepatic artery buffer response following left portal vein ligation: its role in liver tissue homeostasis \[J\]. Am J Physiol， 1999; 277(5 Pt 1)∶G1000.
7. 　Yokoyama Y, Baveja R, Sonin N, et al. Hepatic neovascularization after partial portal vein ligation: novel mechanism of chronic regulation of blood flow \[J\]. Am J Physiol Gastrointest Liver Physiol， 2001; 280(1)∶21.
8. 　Bilodeau M, Aubry MC, Houle R, et al. Evaluation of hepatocyte injury following partial ligation of the left portal vein \[J\]. J Hepatol， 1999; 30(1)∶29.
9. 　Fausto N, Laird AD, Webber EM. Liver regeneration. 2. Role of growth factors and cytokines in hepatic regeneration \[J\]. FASEB J， 1995; 9(15)∶1527.
10. 　Picard C, Starkel P, Sempoux C, et al. Molecular mechanisms of apoptosis in the liver of rats after portal branch ligation with and without retrorsine \[J\]. Lab Invest， 2004; 84(5)∶618.
11. 　Hashimoto M, Watanabe G. Changes in functional capacity after portal branch ligation in rats \[J\]. Surg Today， 2001; 31(12)∶1065.
12. 　Schwartz JD, Schwartz M, Mandeli J, et al. Neoadjuvant and adjuvant therapy for resectable hepatocellular carcinoma: review of the randomised clinical trials \[J\]. Lancet Oncol， 2002; 3(10)∶593.
13. 　Elias D, Debaere T, Roche A, et al. Preoperative selective portal vein embolizations are an effective means of extending the indications of major hepatectomy in the normal and injured liver \[J\]. Hepatogastroenterology， 1998; 45(19)∶170.
14. 　Taniguchi H, Daidoh T, Shioaki Y, et al. Blood supply and drug delivery to primary and secondary human liver cancers studied with in vivo bromodeoxyuridine labeling\[J\]. Cancer, 1993； 71（1）∶50.
15. 　 Kinoshita H, Sakai K, Hirohashi K, et al. Preoperative portal vein embolization for hepatocellular carcinoma \[J\].World J Surg， 1986; 10(5)∶803.
16. 　Castaing D, Garden OJ, Bismuth H. Segmental liver resection using ultrasound-guided selective portal venous occlusion \[J\]. Ann Surg， 1989; 210(1)∶20.
17. 　Matsumata T, Kanematsu T, Takenaka K, et al. Lack of intrahepatic recurrence of hepatocellular carcinoma by temporary portal venous embolization with starch microspheres \[J\]. Surgery， 1989; 105(2 Pt 1)∶188.
  1. 1. 　Tanaka H, Hirohashi K, Kubo S, et al. Preoperative portal vein embolization improves prognosis after right hepatectomy for hepatocellular carcinoma in patients with impaired hepatic function \[J\]. Br J Surg， 2000; 87(7)∶879.
  2. 2. 　葛敦鈞， 錢　峰. 肝癌預(yù)治療后二期切除時機的探討 \[J\]. 中華肝膽外科雜志， 1998; 5（5）∶331.
  3. 3. 　Shimamura T, Nakajima Y, Une Y, et al. Efficacy and safety of preoperative percutaneous transhepatic portal embolization with absolute ethanol: a clinical study \[J\]. Surgery， 1997; 121(2)∶135.
  4. 4. 　湯釗猷主編. 原發(fā)性肝癌研究與進展 \[M\]. 上海: 上海醫(yī)科大學(xué)出版社， 1990∶86~89.
  5. 5. 　陸　森， 錢建民， 黃海清， 等. 幾種不同預(yù)測大鼠肝臟體積（重量）方法的比較 \[J\]. 中華實驗外科雜志， 2002; 19（3）∶252.
  6. 6. 　Rocheleau B, Ethier C, Houle R, et al. Hepatic artery buffer response following left portal vein ligation: its role in liver tissue homeostasis \[J\]. Am J Physiol， 1999; 277(5 Pt 1)∶G1000.
  7. 7. 　Yokoyama Y, Baveja R, Sonin N, et al. Hepatic neovascularization after partial portal vein ligation: novel mechanism of chronic regulation of blood flow \[J\]. Am J Physiol Gastrointest Liver Physiol， 2001; 280(1)∶21.
  8. 8. 　Bilodeau M, Aubry MC, Houle R, et al. Evaluation of hepatocyte injury following partial ligation of the left portal vein \[J\]. J Hepatol， 1999; 30(1)∶29.
  9. 9. 　Fausto N, Laird AD, Webber EM. Liver regeneration. 2. Role of growth factors and cytokines in hepatic regeneration \[J\]. FASEB J， 1995; 9(15)∶1527.
  10. 10. 　Picard C, Starkel P, Sempoux C, et al. Molecular mechanisms of apoptosis in the liver of rats after portal branch ligation with and without retrorsine \[J\]. Lab Invest， 2004; 84(5)∶618.
  11. 11. 　Hashimoto M, Watanabe G. Changes in functional capacity after portal branch ligation in rats \[J\]. Surg Today， 2001; 31(12)∶1065.
  12. 12. 　Schwartz JD, Schwartz M, Mandeli J, et al. Neoadjuvant and adjuvant therapy for resectable hepatocellular carcinoma: review of the randomised clinical trials \[J\]. Lancet Oncol， 2002; 3(10)∶593.
  13. 13. 　Elias D, Debaere T, Roche A, et al. Preoperative selective portal vein embolizations are an effective means of extending the indications of major hepatectomy in the normal and injured liver \[J\]. Hepatogastroenterology， 1998; 45(19)∶170.
  14. 14. 　Taniguchi H, Daidoh T, Shioaki Y, et al. Blood supply and drug delivery to primary and secondary human liver cancers studied with in vivo bromodeoxyuridine labeling\[J\]. Cancer, 1993； 71（1）∶50.
  15. 15. 　 Kinoshita H, Sakai K, Hirohashi K, et al. Preoperative portal vein embolization for hepatocellular carcinoma \[J\].World J Surg， 1986; 10(5)∶803.
  16. 16. 　Castaing D, Garden OJ, Bismuth H. Segmental liver resection using ultrasound-guided selective portal venous occlusion \[J\]. Ann Surg， 1989; 210(1)∶20.
  17. 17. 　Matsumata T, Kanematsu T, Takenaka K, et al. Lack of intrahepatic recurrence of hepatocellular carcinoma by temporary portal venous embolization with starch microspheres \[J\]. Surgery， 1989; 105(2 Pt 1)∶188.