Mashiko H
Nihon Heikatsukin Gakkai Zasshi. 1981 Sep;17(3):115-30.
Selective proximal vagotomy (SPV) has been adopted for the treatment of duodenal ulcer, combined with or without drainage operation. This study is aimed to determine whether the drainage operation is necessary or not following SPV, viewed from gastric motility in dogs. A total of twenty-three mongrel dogs were used, and divided into four experimental groups. They are control, pyloroplasty, SPV, and SPV with pyloroplasty. Electromyographic recordings were made after the fifth post operative day, during the fasted state and after feeding. Results are summarized as follows. 1. The pattern in a frequency change of pacesetter potentials (PPs) was characteristic in those four groups of animals following three different test meals given, hot milk, cold milk, or solid meals respectively. 2. The difference in numbers of PPs in the body from those in the antrum was carried out from the occurrence of antiperistalsis in the antrum. The ratio of PPs in the body and the antrums (AB ratio) was considered useful to depict the gastric activity. 3. Low AB ratio and the wide variance in numbers of antral PPs in pyloroplasty and SPV groups indicated slightly lowered antral activity than in control. 4. SPV with pyloroplasty showed most lowered AB ratio, suggesting the possibility that antral activity was most interrupted in this group. 5. Out of these results and previous reports, the effect of pyloroplasty was discussed viewed from gastric emptying. Conclusively pyloroplasty should be avoided when SPV is performed for duodenal ulcer, unless pyloric stenosis is present.
选择性近端迷走神经切断术(SPV)已被用于治疗十二指肠溃疡,可联合或不联合引流手术。本研究旨在从犬的胃动力角度确定SPV术后是否需要进行引流手术。总共使用了23只杂种犬,并将其分为四个实验组。它们分别是对照组、幽门成形术组、SPV组和SPV联合幽门成形术组。在术后第五天、禁食状态下和进食后进行肌电图记录。结果总结如下。1. 在分别给予热牛奶、冷牛奶或固体食物这三种不同测试餐之后,这四组动物的起步电位(PPs)频率变化模式具有特征性。2. 由于胃窦出现逆蠕动,对胃体和胃窦PPs数量的差异进行了研究。胃体和胃窦PPs的比例(AB比例)被认为有助于描述胃活动。3. 幽门成形术组和SPV组的低AB比例以及胃窦PPs数量的广泛差异表明其胃窦活动比对照组略有降低。4. SPV联合幽门成形术组显示出最低的AB比例,表明该组胃窦活动最有可能受到最大程度的干扰。5. 根据这些结果和先前的报告,从胃排空的角度讨论了幽门成形术的效果。结论是,除非存在幽门狭窄,否则在进行SPV治疗十二指肠溃疡时应避免进行幽门成形术。