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评估局部应用苯酚作为实现肝脏自主神经去支配的一种方法。

Evaluation of topical phenol as a means of producing autonomic denervation of the liver.

作者信息

Lautt W W, Carroll A M

出版信息

Can J Physiol Pharmacol. 1984 Jul;62(7):849-53. doi: 10.1139/y84-140.

Abstract

Topical application of 90% phenol around the bile duct, portal vein, and hepatic artery, as well as along each of the three hepatic ligaments was tested for effectiveness of rapid and chronic denervation in cats. Because phenol produces nonselective nerve degeneration, it was assumed that proof of functional sympathectomy was adequate proof of disruption of parasympathetic and afferent nerves as well. Functional sympathetic neurons were evaluated by measuring physiological responses to direct electrical stimulation of the anterior hepatic plexus. Acute or rapid denervation was assessed by the degree of rise in portal blood pressure produced by nerve stimulation. Complete denervation appeared within 20 min and was still present by 80 min postapplication. Chronic denervation was tested by applying the phenol and recovering the cats for 6-14 days. An equal number (n = 6) of sham-denervated cats were compared. Phenol denervation did not alter basal glucose, insulin or glucagon levels, hematocrit, blood pressure, or hepatic glycogen levels. These variables are a good index of stress and metabolic status. Nerve stimulation in the chronic sham group raised portal pressure, arterial pressure, and blood glucose levels, whereas the chronic-denervated group showed no responses. The health of the two groups appeared normal with the sole difference being that the painted tissues were mildly discolored and more adhesions appeared in the phenol-denervated set. Thus phenol is a useful tool for producing hepatic denervation. It is less traumatic, faster, and more certain than surgical denervation. In addition, the hepatic lymphatics can be preserved using the topical application of phenol.

摘要

在猫身上测试了在胆管、门静脉和肝动脉周围以及沿着三条肝韧带分别局部应用90%苯酚对快速和慢性去神经支配的有效性。由于苯酚会导致非选择性神经变性,因此认为功能性交感神经切除术的证据足以证明副交感神经和传入神经也受到了破坏。通过测量对肝前丛直接电刺激的生理反应来评估功能性交感神经元。通过神经刺激引起的门静脉血压升高程度来评估急性或快速去神经支配。完全去神经支配在20分钟内出现,在应用后80分钟时仍然存在。通过应用苯酚并将猫恢复6 - 14天来测试慢性去神经支配。比较了数量相等(n = 6)的假去神经支配猫。苯酚去神经支配未改变基础葡萄糖、胰岛素或胰高血糖素水平、血细胞比容、血压或肝糖原水平。这些变量是应激和代谢状态的良好指标。慢性假手术组的神经刺激会升高门静脉压力、动脉压力和血糖水平,而慢性去神经支配组则无反应。两组的健康状况看起来正常,唯一的区别是涂抹苯酚的组织轻微变色,并且在苯酚去神经支配组中出现了更多粘连。因此,苯酚是产生肝去神经支配的有用工具。它比手术去神经支配创伤更小、速度更快且更确切。此外,使用苯酚局部应用可以保留肝淋巴管。

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