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目的通过门静脉缩窄联合脾静脉结扎的方法,建立大鼠门静脉高压脾功能亢进模型。方法 60只健康雄性SD大鼠按随机数字表法分为假手术组(n=20)、门静脉缩窄组(缩窄组,n=20)和门静脉缩窄联合脾静脉结扎组(联合组,n=20),其中假手术组仅予以开、关腹术,缩窄组予以单纯门静脉主干缩窄术,联合组予以门静脉缩窄联合脾静脉结扎术。造模开始前和造模后7周每周采各组动物外周血行红细胞、白细胞及血小板计数动态观察;于造模开始前和造模后第7周测量各组动物门静脉压力及脾横、长径,于造模后第7周处死动物后计算各组脾指数并观察脾脏组织的病理学变化。结果联合组大鼠外周血血小板及红细胞计数于第3周起明显低于假手术组及缩窄组(P<0.05);而3组白细胞计数各时相间差异均无统计学意义(P>0.05)。第7周时缩窄组及联合组门静脉压力均较术前明显升高(P<0.05),并且明显高于假手术组(P<0.05)。第7周时联合组的脾横径及脾长径较术前明显增大(P<0.05),并且明显大于假手术组及缩窄组(P<0.05),其脾指数亦高于假手术组及缩窄组(P<0.05)。第7周时联合组脾脏有典型的脾功能亢进的病理改变,而另2组未见明显病理改变。结论通过门静脉缩窄联合脾静脉结扎的方法,成功建立了大鼠继发性门静脉高压脾功能亢进模型,该方法手术操作简便、效果稳定,具有良好的科研应用价值。
Objective To establish a portal hypertensive hypersplenism model by portal vein narrowing combined with splenic vein ligation. Methods Sixty healthy male Sprague-Dawley rats were randomly divided into sham operation group (n = 20), portal vein constriction group (n = 20) and portal vein constriction combined with splenic vein ligation group n = 20). The sham operation group was only open and closed abdomen surgery, and the narrowing group was treated with simple portal vein narrowing. The combined group was given portal vein constriction and splenic vein ligation. Before modeling and 7 weeks after model establishment, peripheral blood erythrocytes, white blood cells and platelet counts of each group were collected weekly. Before and 7 weeks after modeling, the portal vein pressure, Pathological changes of spleen were observed after the animals were sacrificed at the 7th week after modeling. Results Compared with the sham operation group and the constriction group, the platelet and erythrocyte counts of the peripheral blood of the combination group were significantly lower than those of the sham operation group and the constriction group at the third week (P <0.05), while there was no significant difference in the leukocyte count between the three groups (P> 0.05 ). At 7 weeks, the portal venous pressure in both the constriction group and the combined group was significantly higher than that before operation (P <0.05), and significantly higher than that in the sham operation group (P <0.05). At 7th week, the mean diameter of spleen, diameter of spleen in the combined group increased significantly compared with that before operation (P <0.05), and significantly higher than that in the sham operation group and the constriction group (P <0.05) Group and constriction group (P <0.05). On the 7th week, the spleen of the combination group showed typical pathological changes of hypersplenism, while no obvious pathological changes were observed in the other two groups. Conclusions The model of splenic hypersplenism secondary to portal hypertension in rats was established successfully by the method of narrowing the portal vein and ligating the splenic vein. The method has the advantages of simple and convenient operation, stable effect and good application value in research.