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本文报告笔者采用保留下腔静脉的一期全肝切除术和门脉肝动脉分期结扎术制作犬的肝昏迷模型的情况、方法和结果。施行了保留下腔静脉全肝切除术12例,门脉肝动脉分期结扎术11例。行THEP时,在完成门腔静脉侧侧吻合后,游离、切断、结扎肝动脉、总胆管,然后结扎肝左外侧静脉,切除左侧叶,顺序如此法切除各肝叶。作PHL时则在完成门腔侧侧吻合后,结扎门脉近肝段后关腹。6～8周后再手术结扎犬动脉。THEP术后平均生存时间为11小时,犬在死亡前都有肝昏迷的临床表现。PHL术后都有慢性肝脑病的临床表现。用以上方法作成的模型可用于肝昏迷的病理生理学和肝昏迷治疗的研究。
This article reports the author’s use of the method of preserving the inferior vena cava by a total hepatectomy and portal hepatic arterial staging to prepare a canine hepatic coma model. The patients underwent total hepatectomy with preservation of inferior vena cava in 12 cases and portal vein hepatic artery ligation in 11 cases. After the THEP was performed, the hepatic artery and the common bile duct were dissociated, ligated, and ligated after the side-to-side anastomosis of the portal vein was completed. The left lateral vein was then ligated and the left lobe was excised. The liver lobes were resected in this order. When PHL is performed, the portal vein is ligated and the abdominal segment is closed after the completion of the side-to-side anastomosis. After 6 to 8 weeks, the canine artery was ligated. The average survival time of THEP was 11 hours. Dogs had clinical manifestations of hepatic coma before death. The clinical manifestations of chronic hepatic encephalopathy after PHL. The model prepared by the above method can be used for the study of the pathophysiology of hepatic coma and treatment of hepatic coma.