Anvari M, Myers J, Malbert C, Horowitz M, Dent J, Jamieson G
Department of Surgery, McMaster University, Hamilton, Ontario, Canada.
J Gastrointest Surg. 2000 Sep-Oct;4(5):526-30. doi: 10.1016/s1091-255x(00)80096-7.
Proximal gastric vagotomy (PGV) has little impact on the normal pattern of solid gastric emptying, despite denervation of the proximal two thirds of the stomach and loss of the proximal gastric pump. In four healthy volunteers and four patients with PGV, we investigated the possible compensatory mechanisms that may come into play after proximal denervation of the stomach. We measured antropyloroduodenal motility with a 10-lumen sleeve/side-hole catheter for 180 minutes after ingestion of a dual-isotope radiolabeled mixed liquid/solid meal. Patients with PGV exhibited faster liquid emptying, but the rate of solid emptying was similar to that in healthy volunteers. The frequency of propagated antropyloric pressure wave was similar between the two groups, but patients with PGV exhibited less isolated pressure waves in the proximal antrum. The amplitude and duration of pressure waves recorded in the distal antrum were significantly increased in the PGV patients as compared to healthy volunteers. Although the pattern of propagated antral contractions and solid gastric emptying remains unchanged after PGV, there is an increase in the amplitude and duration of distal antral contractions, which may compensate for loss of proximal gastric pumping mechanisms.
近端胃迷走神经切断术（PGV）对固体食物在胃内的正常排空模式影响甚微，尽管胃近端三分之二的神经支配已被切断且近端胃泵功能丧失。在4名健康志愿者和4名接受PGV手术的患者中，我们研究了胃近端去神经支配后可能发挥作用的代偿机制。在摄入双同位素放射性标记的混合液体/固体餐食后，我们使用一根10腔套管/侧孔导管测量胃幽门十二指肠的运动情况，持续180分钟。接受PGV手术的患者液体排空速度更快，但固体排空速度与健康志愿者相似。两组之间传播性幽门压力波的频率相似，但接受PGV手术的患者近端胃窦处孤立压力波较少。与健康志愿者相比，PGV患者远端胃窦处记录到的压力波幅度和持续时间显著增加。尽管PGV术后传播性胃窦收缩模式和固体食物在胃内的排空情况保持不变，但远端胃窦收缩的幅度和持续时间有所增加，这可能补偿了近端胃泵机制的丧失。
