Norryd C, Dencker H, Lunderquist A, Olin T
Acta Chir Scand. 1975;141(2):119-28.
The superior mesenteric blood flow was studied with a dye-dilution technique after catheterization of the superior mesenteric artery and vein. The investigation was performed in connection with portography in 22 patients with apparently normal small bowel function. Intra-arterial injection of 5, 10 or 20 mug bradykinin was followed within one minute by an increase, on the average, of 114, 176 and 223% respectively, in the superior mesenteric blood flow. The blood flow was dose-dependent in this range. The estimated vascular resistance decreased by 52, 61 and 67%, respectively. The portal venous pressure was increased slightly after intra-arterial injection, but the pressure was unchanged after intra-portal injection. Intra-arterial injection of bradykinin causes a highly improved venous phase at superior mesenteric angiography. This may be due not only to the increased flow but to some extent also to increased capillary permeability produced by bradykinin. Intra-arterial injection of 0.125 and 0.250 IU of vasopressin decreased the superior mesenteric blood flow by 53 and 54%, respectively, within 3 minutes of the injection. The dye-dilution method used was not applicable to blood flow below a level of about 200 ml/min. Continuous infusion of 0.05 IU/min decreased the superior mesenteric blood flow by, on an average, 58%. The portal venous pressure was decreased by 25% after the intra-arterial injection, but no change in pressure was recorded after intra-portal administration. The clinical use of intra-arterial infusion of vasopressin during gastrointenstinal bleeding is discussed.
在肠系膜上动脉和静脉插管后,采用染料稀释技术研究了肠系膜上血流情况。该研究是在22例小肠功能明显正常的患者进行门静脉造影时同步进行的。动脉内注射5、10或20微克缓激肽后,肠系膜上血流平均分别增加114%、176%和223%,且在该范围内血流呈剂量依赖性。估计的血管阻力分别降低了52%、61%和67%。动脉内注射后门静脉压力略有升高,但门静脉内注射后压力无变化。动脉内注射缓激肽可使肠系膜上血管造影的静脉期明显改善,这可能不仅是由于血流增加,还在一定程度上是由于缓激肽导致的毛细血管通透性增加。动脉内注射0.125和0.250国际单位血管加压素后3分钟内,肠系膜上血流分别降低53%和54%。所采用的染料稀释法不适用于低于约200毫升/分钟水平的血流。以0.05国际单位/分钟的速度持续输注可使肠系膜上血流平均降低58%。动脉内注射后门静脉压力降低25%,但门静脉内给药后压力无变化。文中讨论了胃肠道出血时动脉内输注血管加压素的临床应用。