Tárnoky K, Szenohradszky J, Petri G
Institute of Experimental Surgery, University Medical School, Szeged, Hungary.
Acta Chir Hung. 1987;28(4):287-98.
Plasma catecholamine concentrations were compared in a group of postoperative "paralytic" ileus patients and in another group of patients, who had undergone medium-size abdominal operations followed by uneventful recovery. The plasma epinephrine level was significantly in the former group, whereas no such difference was observed in the norepinephrine concentration. The data appear to confirm that the epinephrine released from the adrenal medulla appreciably contributes to the development of "paralytic" ileus. The therapeutically effective major tranquillizer and alpha-receptor blocking drug, trifluperidol, was found to reduce both epinephrine and norepinephrine levels in "paralytic" ileus patients. The decrease of the plasma epinephrine level was the higher, the greater its initial concentration. These findings seem to support the decisive role of increased catecholamine release in the development of postoperative motor inhibition ("postoperative" ileus) and also explain the success of sympatholytic treatment in such cases, i.e. the return of normal peristalsis.
对一组术后“麻痹性”肠梗阻患者和另一组接受中等规模腹部手术且恢复顺利的患者的血浆儿茶酚胺浓度进行了比较。前一组患者的血浆肾上腺素水平显著升高,而去甲肾上腺素浓度未观察到此类差异。数据似乎证实,肾上腺髓质释放的肾上腺素明显促成了“麻痹性”肠梗阻的发生。发现具有治疗效果的主要镇静剂和α受体阻断药物三氟哌多可降低“麻痹性”肠梗阻患者的肾上腺素和去甲肾上腺素水平。血浆肾上腺素水平下降幅度越大,其初始浓度越高。这些发现似乎支持了儿茶酚胺释放增加在术后运动抑制(“术后”肠梗阻)发生中的决定性作用,也解释了在这类病例中交感神经阻滞治疗的成功,即正常蠕动的恢复。