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目的 以犬为研究对象 ,研究不同温度 (4 5℃、5 0℃、5 5℃、60℃、65℃ )的热灌注液经肝动脉灌注对犬肝内温度 ,肝组织学及肝、肾功能的动态影响 ,为介入性热化疗的临床应用提供实验依据。方法 经犬肝动脉灌注入 45℃、5 0℃、5 5℃、60℃、65℃生理盐水 180ml,持续 3 0min。观察并比较热灌注前后肝脏穿刺活检及肝、肾功能的动态变化情况。结果 (1)谷丙转氨酶 (alanineamin otransferase ,ALT)、谷草转氨酶 (aspartatetransaminase ,AST)于灌注 (60℃ )后 2 4h开始升高 ,72h达到高峰 (Ρ <0 .0 1) ,168h后逐渐下降 ,2 16h后恢复正常 ;总胆红素 (totalbilirubin ,T -BIL)、白蛋白 (albumin ,ALB)、γ -谷氨酰基移换酶 (γ -glutamyltransferase ,γ -GT)无明显变化 (Ρ >0 .0 5 ) ;(2 )肝组织可见一过性淋巴细胞浸润、肝细胞混浊肿胀 ,168h后恢复正常 ;(3 )肾功能尿素氮 (bloodureanitro gen ,BUN)、肌酐 (creatinine ,Cr)无显著性变化 (Ρ >0 .0 5 ) ,尿酸 (uricacid ,UA)呈一过性增高 (Ρ <0 .0 5 ) ;(4 ) 45℃～ 5 5℃热灌注对肝肾功无显著影响 ,65℃热灌注后肝肾功恢复缓慢。结论 经肝动脉 60℃灌注液介入性热疗是安全的 ,仅引起犬肝组织一过性损伤 ,对肝、肾功能产生一过性影响
Objective To study the effects of hepatic artery perfusion with different temperature (45 ℃, 50 ℃, 55 ℃, 60 ℃, 65 ℃) on hepatic temperature, liver histology and liver and kidney Function of the dynamic impact of the clinical application of interventional thermochemotherapy to provide experimental evidence. Methods The dogs were perfused with 180ml of normal saline at 45 ℃, 50 ℃, 55 ℃, 60 ℃ and 65 ℃ for 30min. The dynamic changes of liver biopsy and liver and kidney function before and after thermal perfusion were observed and compared. Results (1) Alanine aminotransferase (ALT) and aspartate transaminase (AST) began to increase at 24 hours after perfusion (60 ℃), reached the peak at 72 hours (P <0.01), and gradually decreased after 168 hours , Returned to normal after 2 ~ 16h; There was no significant change in total bilirubin (T-BIL), albumin (ALB), γ-glutamyltransferase (γ- 0.05). (2) A transient lymphocytic infiltration was observed in liver tissues, swelling of the hepatocytes was cloudy and returned to normal after 168 hours. (3) Blood urea nitrogen (BUN), creatinine (Cr) Significant changes (P> 0.05), uric acid (UA) showed a transient increase (P <0.05); (4) 45 ℃ ~ 55 ℃ heat perfusion on liver and kidney function had no significant effect , 65 ℃ after liver perfusion heat recovery slowly. Conclusions Interventional hyperthermia via perfusion of hepatic artery at 60 ℃ is safe and only causes transient damage to liver of dogs and has a transient effect on liver and renal function