Tanaka Kunihiko, Tsuchiya Yo, Ree Ken, Morita Hironobu
Department of Physiology, Gifu University, 40 Tsukasa, Gifu 500-8705, Japan.
World J Surg. 2002 Dec;26(12):1412-7. doi: 10.1007/s00268-002-6447-9. Epub 2002 Sep 26.
To examine neural control of renal function during pneumoperitoneum, renal sympathetic nerve activity (RSNA) was measured in pentobarbital-anesthetized rats that had their entire nervous system intact or that had undergone lower thoracic dorsal rhizotomy or abdominal vagotomy. During pneumoperitoneum with intraabdominal pressure (IAP) of 10 mmHg, the mean arterial pressure did not change, but central venous pressure increased by 10 mmHg in all groups. In intact rats, the RSNA increased to 285 +/- 22% during pneumoperitoneum and gradually recovered after release of the insufflation. The RSNA responses decreased during pneumoperitoneum in rats with dorsal rhizotomy or vagotomy compared to responses in intact rats. In intact rats the urine volume and Na+ excretion decreased during pneumoperitoneum and increased just after insufflation release. Dorsal rhizotomy, vagotomy, or renal denervation did not alter the antidiuretic and antinatriuretic responses during pneumoperitoneum; however, diuretic and natriuretic responses were completely abolished by either of these denervations following insufflation release. These results suggest that oliguria during pneumoperitoneum was not due to neural control of renal function but probably to a mechanical influence induced by the elevated IAP. On the other hand, diuretic and natriuretic responses after insufflation release were thought to be a neurally mediated response.
为研究气腹期间肾功能的神经控制,在戊巴比妥麻醉的大鼠中测量肾交感神经活动(RSNA),这些大鼠的整个神经系统完整,或已接受下胸段背根切断术或腹部迷走神经切断术。在腹内压(IAP)为10 mmHg的气腹期间,所有组的平均动脉压均未改变,但中心静脉压升高了10 mmHg。在完整大鼠中,气腹期间RSNA增加至285±22%,放气后逐渐恢复。与完整大鼠相比,背根切断术或迷走神经切断术大鼠在气腹期间的RSNA反应降低。在完整大鼠中,气腹期间尿量和Na+排泄减少,放气后立即增加。背根切断术、迷走神经切断术或肾去神经支配并未改变气腹期间的抗利尿和利钠反应;然而,放气后这些去神经支配中的任何一种都完全消除了利尿和利钠反应。这些结果表明,气腹期间的少尿并非由于肾功能的神经控制,而可能是由于升高的IAP引起的机械影响。另一方面,放气后的利尿和利钠反应被认为是一种神经介导的反应。