A Study On Effects Of Hepatic Vascular Exclusion Methods To Hepatic Ischemia Reperfusion Injury

Objective:1. Through the animal experimental study, discussion pure portal veinexclusion group and total hepatic vascular exclusion impact on hepatic ischemiareperfusion injury.2. Through clinical research, discussion total hepatic vascular exclusion, halfhepatic vascular exclusion and regional hepatic vascular exclusion impact on liverfunction after operation.Methods:1. Select60healthy male SD rats, were randomly divided into2groups(n=30). Pure portal vein exclusion and total hepatic vascular exclusion on twogroups of rats were. Block30minutes after reperfusion for1,3,6,12,24hours ofdetermination of serum ALT and AST content of liver tissue, determination of MDAand MPO content and liver tissue HE staining observation of liver tissue injury.2. The date from2005to2010,the clinical patients for anatomical hepatectomywere retrospectively analyzed；The54patients received hepatectomy with total hepaticvascular exclusion, the22patients received hepatectomy with half hepatic vascularexclusion, and the34patients received hepatectomy with regional hepatic vascularexclusion. All of110patients pathologically confirmed hepatocellular carcinoma, andthe hospitalization time is more the7days. According to compare to liver function inpre-operation and3periods of post-operation，1st day，4th day and7th day，evaluaterecovery of liver function of post-operation patients. Discussion different ways tohepatic vascular exclusion impact on liver function after operation.Results:1. Different time points(1,3,6,12,24h), the serum ALT, AST content ofpure portal vein exclusion group rat is lower than total hepatic vascular exclusion grouprat(P<0.05). The liver tissue MDA, MPO content of pure portal vein exclusion grouprat is lower than the other group(P<0.05).Under the microscope, HE stainingobservation and cell count, the injury of rats liver tissue of pure portal vein exclusion group is slighter than the others(P<0.05).2. the liver function of regional hepatic vascular exclusion(ALT311±80U/L，TB22.2±8.3μmol/L) is absolutely better than the liver function of total hepatic vascularexclusion(ALT874±299U/L、TB42.9±19.1μmol/L) in the1st day of post-operationpatients．And in the7th day of post-operation, the liver function of regional hepaticvascular exclusion(ALT58±17U/L，TB11.3±3.1μmol/L) is absolutely better thanthe liver function of total hepatic vascular exclusion(ALT108±52U/L，TB14.6±9.2μmol/L), too.Conclusions:1. The hepatic ischemia reperfusion injury in pure portal veinexclusion group is slighter than that in total hepatic vascular exclusion group. It hascertain application value in clinical work.2. Compared with the method of total hepatic vascular exclusion, the method ofregional hepatic vascular exclusion can effectively reduce hepatic injury duringoperation and promote recovery of liver function after operation.