Seufert R M, Encke A, Hottenrott C
Z Gastroenterol. 1981 Apr;19(4):189-95.
A gastric irrigation by an open naso-gastric tube with ice-solutions is a standard procedure in the management of upper gastrointestinal bleeding. In 6 dogs the effect of an increased intragastric pressure and of gastric cooling upon gastric blood flow was examined, using radioactive microspheres. Filling the stomach with saline solution of 38 degrees C to an intragastric pressure of 15 cm H2O reduces canine gastric blood flow from 21,3 +/- 4,4 ml X 100 g-1 X min-1 to 12,6 +/- 2,9 ml significantly. Probably as a consequence of compression only mucosal blood flow is lowered. Blood flow during local hypothermia (21 degrees C at the outer wall of the stomach) at the same intragastric pressure is 60% less than the control value at empty stomach and 33% less than the value at increased pressure without lowered temperature (p less than 0,01). Blood flow to the muscularis is now reduced too. This may be explained by vasoconstriction. However, local hypothermia causes the stomach wall bleeding time to increase three times (13), whereas irrigation by 38 degrees C fluid doesn't alter the coagulation of blood. An irrigation with high volumes of a fluid with body-temperature, which lowers gastric blood flow without changing coagulation and with an open system, which allows the cleaning of the stomach, seems to be more valuable than local hypothermia by a ballon system.
通过开放的鼻胃管使用冰溶液进行胃灌洗是上消化道出血管理中的标准程序。在6只狗身上，使用放射性微球研究了胃内压力升高和胃冷却对胃血流量的影响。用38℃的盐溶液将胃充盈至胃内压力为15 cm H₂O时，犬胃血流量从21.3±4.4 ml×100 g⁻¹×min⁻¹显著降低至12.6±2.9 ml。可能仅由于压迫，黏膜血流量降低。在相同胃内压力下局部低温（胃外壁温度为21℃）时的血流量比空腹时的对照值少60%，比未降低温度但压力升高时的值少33%（p＜0.01）。此时肌层的血流量也减少了。这可能是由血管收缩解释的。然而，局部低温会使胃壁出血时间增加三倍（13），而用38℃的液体灌洗不会改变血液凝固。用大量体温液体进行灌洗，在不改变凝血的情况下降低胃血流量，且采用开放系统以便清洁胃，似乎比通过球囊系统进行局部低温更有价值。
