探讨淤血肝组织切除对大鼠肝切除术后早期残肝功能的影响。

健康雄性SD大鼠75只，按随机数字表法随机分为3组，各25只。非淤血组：肝中叶+左叶切除；淤血组：肝中叶+左叶切除+尾状叶静脉结扎淤血；淤血切除组：肝中叶+左叶切除+尾状叶静脉结扎淤血3 min后切除。术后24 h检测血TB，并行肝组织病理学检查，免疫组化法检测肝组织CD68标记的巨噬细胞浸润情况，Western blot检测cleaved casepase-3蛋白表达。观察3组TB、肝组织病理学检查情况、cleaved casepase-3蛋白表达以及生存情况。检测指标比较采用单因素方差分析和LSD-t检验，生存分析采用Kaplan-Meier曲线和Log-rank检验。

术后24 h非淤血组、淤血组、淤血切除组TB分别为（15.9±1.7）、（19.3±2.0）、（16.4±1.5）μmol/L，淤血组明显高于非淤血组、淤血切除组（LSD-t= 3.14，2.68；P<0.05）。淤血组空泡样变性细胞、巨噬细胞较非淤血组增多，而淤血切除组空泡样变性细胞、巨噬细胞减少。淤血组肝组织cleaved casepase-3蛋白表达强于非淤血组及淤血切除组。3组大鼠术后总体生存率分别为75%、15%、60%，淤血组明显低于非淤血组和淤血切除组（χ² = 14.3，8.1；P<0.05）。

淤血肝组织切除能明显改善大鼠肝切除术后早期残肝功能损害，并降低大鼠死亡率，其机制可能与减少细胞凋亡和减轻炎症反应有关。

To investigate the effect of resection of congested liver tissue on remnant liver function in early stage after hepatectomy in rats.

Seventy-five healthy, male Sprague-Dawley rats were randomly divided into three groups according to the random number table method with 25 rats in each group. In the non-congestion group, middle and left lobectomy of liver was performed. In the congestion group, middle and left lobectomy of liver + caudate lobe venous ligation and congestion was performed. In the congestion and resection group, middle and left lobectomy of liver was performed, and the caudate lobe was resected after venous ligation and congestion for 3 min. At 24 h after operation, the level of total bilirubin (TB) was detected, and liver tissue was collected for pathological examination, the infiltration of cluster of differentiation (CD) 68 labeled-macrophage was detected by immunohistochemical method, and the expression of cleaved casepase-3 protein was detected by Western blot. The level of TB, results of pathological examination, expression of cleaved casepase-3 protein and the survival of rats in three groups were observed. The test indexes were compared using one way analysis of variance and LSD-t test, and the survival analysis was conducted using Kaplan-Meier curve and Log-rank test.

At 24 h after operation, the levels of TB in the congestion group was (19.3±2.0) μmol/L, significantly higher than (15.9±1.7) μmol/L in the non-congestion group and (16.4±1.5) μmol/L in the congestion and resection group (LSD-t=3.14, 2.68; P<0.05). Compared with those in the non-congestion group, vacuolar degeneration of hepatocytes and macrophage obviously increased in the congestion group. However, the vacuolar degeneration of hepatocytes and macrophage obviously reduced in the congestion and resection group. The expression of cleaved casepase-3 protein in the liver tissue in the congestion group was significantly higher than that in the non-congestion group and the congestion and resection group. The overall survival rate in the congestion group was 15%, significantly lower than 75% in the non-congestion group and 60% in the congestion and resection group (χ²=14.3, 8.1; P<0.05).

Resection of the congested liver tissue can obviously improve the remnant liver function in early stage after hepatectomy and reduce the mortality of rats, probably through the mechanism of reducing cell apoptosis and alleviating inflammatory response.