Wang D, Yan J, Li W, Li Y
Department of General Surgery, Daping Hospital, Third Military Medical College, Chongqing.
Chin Med J (Engl). 1995 Dec;108(12):923-7.
To elucidate the effects of highly selective vagotomy plus mucosal antrectomy (HSV-MA) antral functions, eighteen dogs were randomly divided into control, HSV and HSV-MA group for determining gastric emptying, antral myoelectric activity and antral pressure. The tests were performed 4 months after operation in the HSV-MA and HSV group. By roentgenoscopy, the gastric and duodenal shape were normal, and gastric peristalsis was clearly seen in all the dogs in the three groups. The beginning and ending time of gastric emptying in the HSV-MA group were 5.0 +/- 0.06 minutes and 4.0 +/- 0.4 hours respectively, which were similar to those in the control and HSV group (P > 0.05). The frequency of antral myoelectric action potential in the HSV-MA group (3.11 +/- 0.65 cycles/minutes) was significantly lower than those in the control and HSV group (P < 0.05). Intramuscular injection of pentagastrin significantly increased the frequency of antral myoelectric action potential (P < 0.01) in all groups, and eliminated the difference among them before the injection. The antral pressure wave occurred immediately following the antral myoelectric action potential waves. The antral pressure values in the control and HSV-MA group were similar (P > 0.05), and were significantly lower than that in the HSV group (P < 0.05). Intramuscular injection of pentagastrin significantly increased the antral pressure (P < 0.001) in all groups and eliminated the difference among them before the injection. These evidences suggest that the motor function of the reconstructed antrum following HSV-MA nearly reached normal level despite a lower antral myoelectric frequency. Combined with other reports, HSV-MA has a good clinical prospect as an operation for the treatment of chronic duodenal ulcer.
为阐明高选择性迷走神经切断术加胃窦黏膜切除术（HSV-MA）对胃窦功能的影响，将18只犬随机分为对照组、HSV组和HSV-MA组，以测定胃排空、胃窦肌电活动和胃窦压力。在HSV-MA组和HSV组术后4个月进行检测。通过X线透视检查，三组所有犬的胃和十二指肠形态正常，且可见明显的胃蠕动。HSV-MA组胃排空的起始时间和结束时间分别为5.0±0.06分钟和4.0±0.4小时，与对照组和HSV组相似（P>0.05）。HSV-MA组胃窦肌电动作电位频率（3.11±0.65次/分钟）显著低于对照组和HSV组（P<0.05）。肌肉注射五肽胃泌素可显著增加所有组胃窦肌电动作电位频率（P<0.01），并消除注射前各组之间的差异。胃窦压力波紧跟胃窦肌电动作电位波之后出现。对照组和HSV-MA组的胃窦压力值相似（P>0.05），且显著低于HSV组（P<0.05）。肌肉注射五肽胃泌素可显著增加所有组的胃窦压力（P<0.001），并消除注射前各组之间的差异。这些证据表明，HSV-MA术后重建胃窦的运动功能尽管胃窦肌电频率较低，但几乎达到正常水平。结合其他报道，HSV-MA作为治疗慢性十二指肠溃疡的手术具有良好的临床前景。
