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本实验通过建立扑热息痛致狗急性肝功能衰竭模型,观察了肝脏血流动力学改变和外周及内脏血管床血浆儿茶酚胺浓度的变化。结果为:急性肝功能衰竭时门静脉阻力明显增加,肝动脉血管阻力下降;门静脉血流量明显减少,总肝血流量亦明显降低,肝动脉血流量、门静脉压力及嵌塞静脉压力均无明显变化;门静脉、肝静脉、腹主动脉、下腔静脉血浆去甲肾上腺素浓度均明显增加。后者可能收缩门脉血管床,增加门静脉阻力、参与和/或加重肝循环障碍,本研究支持用酚妥拉明等α受体阻滞剂治疗急性肝功能衰竭时肝脏血流动力学障碍。
In this study, we established a model of paracetamol induced acute liver failure in dogs and observed the changes of hepatic hemodynamics and plasma catecholamine concentrations in peripheral and visceral vascular beds. The results showed that the resistance of portal vein was significantly increased and the resistance of hepatic artery was decreased in acute liver failure. The blood flow of portal vein was significantly reduced and the total hepatic blood flow was also significantly decreased. There was no significant change in hepatic artery blood flow, portal vein pressure and occlusive vein pressure. Portal vein, hepatic vein, abdominal aorta, inferior vena cava plasma norepinephrine concentrations were significantly increased. The latter may shrink the portal vein beds, increase portal resistance, participate in and / or aggravate hepatic circulation disorders and this study supports the use of phentolamine and other alpha blockers in the treatment of hepatic hemodynamic disorders in acute liver failure.