Shikata J, Kohno K, Shida T, Miyaji S, Kohdaira F
Department of Surgery, Teikyo University School of Medicine, Tokyo, Japan.
Surgery. 1989 Nov;106(5):879-83.
In model experiments with mongrel dogs, intestinal strangulation obstruction was induced by occluding the superior mesenteric veins, and a rise in the inorganic phosphate value of the blood was observed. The high inorganic phosphate values of the fluid exuding from the strangulated bowel suggest that intestinal factors associated with the strangulated bowel may be partly responsible for this elevated phosphatemia. However, hyperphosphatemia was also found in a model experiment in which the route through which the fluid was absorbed into the blood from the peritoneal cavity was interrupted by keeping the strangulated bowel in an intestinal bag. After this, in the model experiments in which a systemic blood pressure depression curve with a percentage reduction similar to that of the decreasing arterial blood pressure resulting from strangulation was produced (by exsanguination, and even by exsanguination with adequate perfusion of the gut), plasma inorganic phosphate values also increased. Therefore it is undeniable that systemic factors other than the above-mentioned local factors are related to the rise in plasma inorganic phosphate values in experimental strangulation obstruction. Because it is not possible to assert that phosphatemia is specific to intestinal strangulation, the importance of a rise in inorganic phosphate values in the early diagnosis of intestinal strangulation cannot be considered very great.
在对杂种狗进行的模型实验中，通过阻断肠系膜上静脉诱导肠绞窄性梗阻，并观察到血液中无机磷值升高。从绞窄肠段渗出的液体中无机磷值较高，这表明与绞窄肠段相关的肠道因素可能部分导致了这种高磷血症。然而，在一个模型实验中也发现了高磷血症，在该实验中，通过将绞窄肠段置于肠袋中，中断了液体从腹腔吸收进入血液的途径。此后，在通过放血（甚至在肠道充分灌注的情况下放血）产生与绞窄导致的动脉血压下降百分比相似的全身血压下降曲线的模型实验中，血浆无机磷值也升高。因此，不可否认的是，除了上述局部因素外，全身因素也与实验性绞窄性梗阻中血浆无机磷值的升高有关。由于不能断言高磷血症是肠绞窄所特有的，所以无机磷值升高在肠绞窄早期诊断中的重要性不能被认为非常大。
