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选择性近端迷走神经切断术后的血流变化会导致胃壁坏死吗?

Are bloodflow changes after selective proximal vagotomy responsible for a necrosis in the gastric wall?

作者信息

Seifert J, Lenz J, Brückner W, Brendel W, Holle F

出版信息

Res Exp Med (Berl). 1980;177(3):263-6. doi: 10.1007/BF01851217.

Abstract

Animal experiments were performed to investigate bloodflow distribution before and after selective vagotomy to explain gastric mucosa necrosis found in some patients after vogtomy. Flow measurements were made using the microsphere technique. Changes in the microcirculation were determined under basal and stimulated conditions (250 mg 2-desoxy-D-glucose). After selective vagotomy a reduction in bloodflow of up to 50% could be observed in all layers of the stomach. There were no differences in the bloodflow along either the lesser or greater curvature under basal conditions. In the stimulated stomach, however, the increase in bloodflow along the lesser curvature was higher, although the vessels of this region were mostly altered by SPV operative procedure. From these results it can be concluded that a reducton of arterial input after selective proximal vagotomy is probably compensated for by intramucosal or submucosal anastomoses. Therefore, necrosis in the gastric wall is not due to SPV but probably to other accompanying diseases.

摘要

进行动物实验以研究选择性迷走神经切断术前和术后的血流分布,以解释部分患者在迷走神经切断术后出现胃黏膜坏死的原因。使用微球技术进行血流测量。在基础状态和刺激状态(250mg 2-脱氧-D-葡萄糖)下测定微循环的变化。选择性迷走神经切断术后,可观察到胃各层血流减少高达50%。在基础状态下,沿胃小弯或胃大弯的血流没有差异。然而,在受刺激的胃中,尽管该区域的血管大多因选择性近端迷走神经切断术(SPV)手术操作而改变,但沿胃小弯的血流增加更高。从这些结果可以得出结论,选择性近端迷走神经切断术后动脉输入的减少可能通过黏膜内或黏膜下吻合得到补偿。因此,胃壁坏死不是由于选择性近端迷走神经切断术,而可能是由于其他伴随疾病。

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