Saito H
Surgical Center, University of Tokyo, Japan.
Nihon Geka Gakkai Zasshi. 1996 Sep;97(9):701-7.
The similar response is elicited by different surgical stress for the maintenance of homeostasis. The afferent neurogenic stimuli initiate the endocrine response. The production of inflammatory cytokines also stimulates the neuroendocrine system. Activation of the sympathoadrenal, hypothalmo-pituitary-adrenal axis, and renin-angiotensin-aldosterone-axis results in increased serum concentrations of stress hormones. The endocrine alterations provide the optimal hemodynamic, metabolic and immunologic response. Such response to surgical stress is highly complex. However, a better understanding of the mechanisms may lead to improved strategies of the treatment for critical surgical illness. This article focuses on the mechanisms of the neuroendocrine system activation by surgical injury and the role of the response for maintaining homeostasis.
不同的手术应激会引发类似的反应以维持体内平衡。传入神经源性刺激引发内分泌反应。炎性细胞因子的产生也会刺激神经内分泌系统。交感肾上腺、下丘脑-垂体-肾上腺轴以及肾素-血管紧张素-醛固酮轴的激活会导致应激激素的血清浓度升高。内分泌改变提供了最佳的血流动力学、代谢及免疫反应。这种对手术应激的反应非常复杂。然而,更好地理解其机制可能会带来针对严重外科疾病的改进治疗策略。本文聚焦于手术损伤激活神经内分泌系统的机制以及该反应在维持体内平衡中的作用。