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目的:探讨一种理想的急性肝衰竭(AHF)模型建立方法。方法:36只实验兔随机分为3组:①改良药物手术诱导组(A组,n=12),先用D-氨基半乳糖(D-Galn)和脂多糖(LPS)腹腔注射,同时加用乳果糖,注射后2h以氟烷作为麻醉剂,切除约50%肝脏组织,术中经肝静脉注入5%葡萄糖氯化钠溶液10ml/kg体重;②传统手术诱导组(B组,n=12),切除约95%肝脏组织,术中不行肝静脉穿刺注射5%葡萄糖氯化钠溶液;③药物诱导组(C组,n=12),用D-氨基半乳糖(D-Galn)和脂多糖(LPS)一次性腹腔注射。比较建模死亡率、建模后24h兔存活率、血谷丙转氨酶(ALT)、血氨(NH3)、总胆红素(TB)和血糖(BS)。结果:B组手术死亡率高于A组死亡率(41.77%vs0%),A组、B组兔建模成功后24h存活率及C组兔建模成功后72h存活率分别为0%,0%,25%,A组ALT和NH3水平显著高于C组(P<0.05),TB和BG水平低于C组,但差异无显著性。结论:通过改进的50%肝切除术可建立较理想的兔AHF模型,以氟烷作为麻醉剂,药物诱导注射同时加用乳果糖,术中经中叶肝静脉注入5%葡萄糖氯化钠溶液可减少手术死亡率。
Objective: To explore an ideal method for establishing a model of acute liver failure (AHF). Methods: Thirty-six experimental rabbits were randomly divided into three groups: (1) Group A (n = 12) received modified intraperitoneal injection of D-galactose and lipopolysaccharide (LPS) With lactulose, 2 hours after injection, halothane was used as an anesthetic to excise about 50% of the liver tissue. Intraoperative hepatic vein was infused with 10ml / kg body weight of 5% dextrose and sodium chloride solution. ② The traditional surgical induction group (group B, n = 12 ), About 95% of the liver tissue was excised. Intravenous hepatic vein puncture was injected with 5% dextrose sodium chloride solution during the operation. ③ The drug-induced group (group C, n = 12) was given D-galactosamine Polysaccharides (LPS) a one-time intraperitoneal injection. The modeling mortality, 24h survival rate of rabbits after modeling, ALT, NH3, TB and BS were compared. Results: The mortality of group B was higher than that of group A (41.77% vs 0%). The survival rates of group A and group B at 24 h after successful modeling and at 72 h after model C were 0% and 0%, respectively %, 25%. The levels of ALT and NH3 in group A were significantly higher than those in group C (P <0.05), and the levels of TB and BG were lower than those in group C, but the difference was not significant. CONCLUSIONS: An ideal rabbit model of AHF can be established through an improved 50% hepatectomy. Hyaluronan is used as an anesthetic and the drug-induced injection plus lactulose is used. Intraoperative hepatic vein infusion of 5% glucose and sodium chloride solution can be reduced Surgical mortality.