Kurygin A A, Gaĭvoronskiĭ I V, Skriabin O N, Lebedev N N, Tikhonova L P, Sidorov V M, Osipov I S, Ivashchenko A A, Chepur S V, Filippov A V
Vestn Khir Im I I Grek. 1992 Jun;148(6):278-84.
The clinico-experimental investigation has shown high efficiency of the bilateral subdiaphragmatic truncal vagotomy in treatment of patients with acute gastroduodenal ulcers complicated by massive hemorrhage. The haemostatic effect of the operation is related to the inhibited acid gastric secretion, proteolytic activity of the intragastric content as well as to the activation of serotonin-containing cells and increased tonus of the sympathetic nervous system, which is responsible for gastric vessel spasm, shortens time of bleeding, increases the amount of thrombocytes and their aggregation. When vagotomy with interventions draining the stomach is not possible, suturing (dissection) of bleeding acute ulcers is recommended in combination with prolonged novocain blockade of vagus nerves.
临床实验研究表明，双侧膈下迷走神经干切断术在治疗并发大量出血的急性胃十二指肠溃疡患者方面具有很高的疗效。该手术的止血效果与胃酸分泌受抑制、胃内内容物的蛋白水解活性有关，还与含5-羟色胺细胞的激活以及交感神经系统张力增加有关，交感神经系统负责胃血管痉挛，可缩短出血时间，增加血小板数量及其聚集。当无法进行迷走神经切断术并同时进行胃引流干预时，建议对出血的急性溃疡进行缝合（剥离），并联合对迷走神经进行长时间的奴夫卡因阻滞。
