Stoitchcov E, Kawai T, Biossel P, Bleser F, Bénichoux R
J Chir (Paris). 1975 Mar;109(3):369-86.
To determine the roles of portal circulation and the hepatic arteries during states of shock, the authors studied on 38 dogs, the effects of 30 minutes clamping of the sub-diaphragmatic part of the inferior vena cava, the portal vein and the hepatic artery, either together or successively. They measured the pressure in these various vessels, the transhepatic flow, using Xenon133, and calculated the intra-hepatic resistance. The animals were then treated with Tham, isoprenaline and propanolol. Tolerance to clamping was improved significantly when the animals were treated with the association of these drugs. The portal pressure and the systemic arterial pressure, rapidly returned to normal. This was also the case with hepatic, venous or arterial blood flow. There was a remarkable stability between the sinusoidal and biliary resistances, compared with disturbances in control groups. The already well known beneficial effect of Tham was increased by the apparently paradoxical association of isoprenaline and propranolol. In fact, with this dosage, they counter-balanced their reciprocal disadvantages. Finally, a study of blood flow and vascular resistance in the liver, suggests the existence of two components in splanchnic shock, hepatic and visceral.
为了确定休克状态下门静脉循环和肝动脉的作用,作者对38只狗进行了研究,观察了下腔静脉膈肌以下部分、门静脉和肝动脉一起或相继夹闭30分钟的影响。他们测量了这些不同血管的压力,使用氙133测量了肝血流量,并计算了肝内阻力。然后给动物使用三羟甲基氨基甲烷(Tham)、异丙肾上腺素和普萘洛尔进行治疗。当动物联合使用这些药物治疗时,对夹闭的耐受性显著提高。门静脉压力和体循环动脉压力迅速恢复正常。肝血流、静脉血流或动脉血流也是如此。与对照组的紊乱情况相比,肝血窦阻力和胆管阻力之间存在显著的稳定性。三羟甲基氨基甲烷(Tham)已为人所知的有益作用因异丙肾上腺素和普萘洛尔这种明显矛盾的联合使用而增强。事实上,在这种剂量下,它们相互抵消了各自的不利之处。最后,对肝脏血流和血管阻力的研究表明,内脏性休克存在肝性和内脏性两个组成部分。