Urakawa T, Nagahata Y, Azumi Y, Hashimoto Y, Itoh A, Takeda K, Sano I, Saitoh Y
First Dept. of Surgery, Kobe University School of Medicine, Japan.
Scand J Gastroenterol. 1988 Aug;23(6):705-11. doi: 10.3109/00365528809093937.
We experimentally studied the influence of vagotomy on hepatic regeneration in rats after hepatectomy of cirrhotic livers. In animals that underwent hepatectomy plus vagotomy the reduction in gastric pH was suppressed, but gastric mucosal blood flow was less than that in control animals that received hepatectomy alone. The suppression of 3H-thymidine uptake percentage and thymidine kinase activity after hepatectomy was more marked in animals treated with hepatectomy plus vagotomy than in controls treated with hepatectomy alone. Hepatic DNA level tended to be lower in animals treated with hepatectomy plus vagotomy than in controls. In animals treated with hepatectomy plus vagotomy, the peak level of the mitotic index was lower and the hepatic regeneration rate was evidently suppressed. These results suggest that it is not appropriate to apply vagotomy, during hepatectomy of cirrhotic livers, for the prevention of postoperative stress ulcer because it causes a marked reduction in gastric mucosal blood flow and suppresses hepatic regeneration.
我们通过实验研究了迷走神经切断术对肝硬化肝脏切除术后大鼠肝再生的影响。在接受肝切除加迷走神经切断术的动物中,胃pH值降低受到抑制,但胃黏膜血流量低于仅接受肝切除术的对照动物。肝切除后,肝切除加迷走神经切断术治疗的动物中3H-胸腺嘧啶核苷摄取百分比和胸苷激酶活性的抑制比仅接受肝切除术治疗的对照动物更明显。肝切除加迷走神经切断术治疗的动物的肝DNA水平倾向于低于对照动物。在接受肝切除加迷走神经切断术治疗的动物中,有丝分裂指数的峰值水平较低,肝再生率明显受到抑制。这些结果表明,在肝硬化肝脏肝切除术中应用迷走神经切断术预防术后应激性溃疡是不合适的,因为它会导致胃黏膜血流量显著减少并抑制肝再生。