Gleysteen J J, Esser M J, Myrvik A L
Gastroenterology. 1983 Sep;85(3):578-83.
Prior attempts at in vivo reversible vagal denervation of the gastrointestinal tract have been limited to cervical cooling techniques that also denervate both sympathetic and vagal pulmonary and cardiac branches. Denervation of vagal efferent fibers at this level has produced results that are inconsistent with those obtained after surgical truncal vagotomy. We have, therefore, developed a technique to provide reversible vagal denervation below the pulmonary and cardiac branches for the study of gastric motility. Five dogs, previously equipped with gastric strain gages and electrodes, underwent implantation of a tubular cooling jacket around a distal thoracic vagal trunk with contralateral vagotomy (4 dogs), or around both vagal trunks (1 dog). The jacket was made of stainless steel tubing in a "J" design. Its inside channel was lined with a sterling silver sheet, and a thermistor was attached to record temperature change. Silicone tubing coursed externally to a pump and flask to which 95% ethanol at -70 degrees C was circulated at variable speeds. Thoracic vagal cooling, extending up to 5 h, reversibly blocked gastric contractions induced by insulin hypoglycemia. Contractile waves were terminated at device temperatures of 2 degrees-6 degrees C but promptly returned with warming. Dogs were tranquil during denervation, and enclosed nerves remained functional for greater than 40 days.
此前在体内对胃肠道进行可逆性迷走神经切断术的尝试仅限于颈部冷却技术,该技术同时也会使交感神经以及迷走神经的肺部和心脏分支失神经支配。在此水平切断迷走神经传出纤维所产生的结果与经手术进行迷走神经干切断术后所获得的结果并不一致。因此,我们开发了一种技术,用于在肺部和心脏分支以下提供可逆性迷走神经切断术,以研究胃动力。五只先前已植入胃应变计和电极的狗,在一侧迷走神经切断术(4只狗)或双侧迷走神经切断术(1只狗)的情况下,在胸段迷走神经干远端植入了一个管状冷却套。该冷却套采用“J”形不锈钢管制成。其内部通道内衬有纯银片,并连接了一个热敏电阻以记录温度变化。硅胶管从外部连接到一个泵和一个烧瓶,-70℃的95%乙醇以可变速度在其中循环。胸段迷走神经冷却长达5小时,可可逆地阻断胰岛素低血糖诱导的胃收缩。当装置温度为2℃至6℃时,收缩波终止,但升温后迅速恢复。在去神经支配期间,狗很安静,被包裹的神经在超过40天的时间里仍保持功能。