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麻醉犬肠系膜上动脉部分机械性梗阻所致门静脉压力降低

Portal pressure reduction induced by partial mechanical obstruction of the superior mesenteric artery in the anesthetized dog.

作者信息

Groszmann R J, Blei A T, Kniaz J L, Storer E H, Conn H O

出版信息

Gastroenterology. 1978 Aug;75(2):187-92.

PMID:669204
Abstract

In an effort to avoid the potentially dangerous side effects of vasopressin infusions, we attempted to reproduce mechanically the splanchnic hemodynamic changes induced by vasopressin without its systemic effects. Superior mesenteric arterial pressure was reduced to 50 to 70 mm Hg for 30 to 60 min in 10 normal dogs by partial balloon obstruction of the superior mesenteric artery. Balloon inflation caused a decrease in portal venous pressure (5.6 +/- 0.6 versus 2.8 +/- 0.7 mm Hg), hepatic vein wedge pressure (4.8 +/- 0.4 versus 2.3 +/- 0.5 mm Hg), and portal vein flow 424 +/- 53 versus 275 +/- 52 ml per min), and an increase in hepatic arterial blood flow (172 +/- 19 versus 217 +/- 29 ml per min). Total hepatic blood flow and oxygen delivery to the liver were unchanged. Partial balloon obstruction caused an increase in cardiac output (1950 +/- 203 versus 2317 +/- 376 ml per min) and mean arterial pressure 138 +/- 6 versus 151 +/- 7 mm Hg), whereas heart rate did not change. Partial balloon obstruction of the superior mesenteric artery caused similar changes in splanchnic hemodynamics to those of vasopressin infusions into the superior mesenteric artery, but without the potential deleterious effects of vasopressin on systemic hemodynamics.

摘要

为避免血管加压素输注可能产生的危险副作用,我们试图通过机械手段重现血管加压素诱导的内脏血流动力学变化,而不产生其全身效应。在10只正常犬中,通过部分球囊阻塞肠系膜上动脉,将肠系膜上动脉压力降至50至70毫米汞柱,持续30至60分钟。球囊充气导致门静脉压力降低(5.6±0.6对2.8±0.7毫米汞柱)、肝静脉楔压降低(4.8±0.4对2.3±0.5毫米汞柱)以及门静脉血流减少(424±53对275±52毫升/分钟),同时肝动脉血流增加(172±19对217±29毫升/分钟)。肝脏总血流量和肝脏氧输送量未发生变化。部分球囊阻塞导致心输出量增加(1950±203对2317±376毫升/分钟)和平均动脉压升高(138±6对151±7毫米汞柱),而心率未改变。肠系膜上动脉部分球囊阻塞引起的内脏血流动力学变化与向肠系膜上动脉输注血管加压素相似,但没有血管加压素对全身血流动力学的潜在有害影响。

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