内脏大神经切断对犬急性坏死性胰腺炎的治疗作用  

Therapeutic effect of greater splanchnic nerve transection in dogs with acute necrotizing pancreatitis

作　　者：张玉明[1] 孙君军[1] 刘伟峰[1] 戚世芳[1] 常永超[1] 

机构地区：[1]河南科技大学第一附属医院普通外科,河南洛阳471003

出　　处：《中国普通外科杂志》2013年第3期270-274,共5页China Journal of General Surgery

摘　　要：目的:探讨内脏大神经切断对犬急性坏死性胰腺炎(ANP)病理生理变化的影响。方法:20只健康杂种犬随机分为假手术组(n=4);ANP模型组(模型组,n=8);ANP模型+双侧内脏大神经阻断组(内脏大神经阻断组,n=8)。ANP模型采用胰管内注射5%牛黄胆酸钠及胰蛋白酶法诱导,内脏大神经阻断组于造模后即行双侧内脏大神经切断。术后动态监测各组血清胰淀粉酶(AMY),血清钙,超敏C反应蛋白(HCRP),肿瘤坏死因子α(TNF-α),白介素10(IL-10)水平;7 d后处死全部动物行病理观察。结果:重复测量分析显示,与假手术组比较,模型组与内脏神经阻断组术后AMY明显升高,血清钙水平明显下降,HCRP,TNF-α,IL-10均明显升高(均P<0.01);模型组与内脏大神经阻断组间AMY水平无统计学差异(P>0.05),而内脏神经阻断组HCRP,TNF-α水平低于模型组,血清钙和IL-10水平高于模型组(均P<0.05)。大体与组织病理学显示,模型组与内脏神经阻断组均有典型ANP病理改变,但内脏大神经阻断组病变程度轻于模型组。结论:切断内脏大神经能减缓犬ANP病理发展进程。Objective： To investigate the influence exerted by greater splanchnic nerve transection on the pathophysiological process of acute necrotizing pancreatitis （ANP） in dogs. Methods： Twenty healthy mongrel dogs were randomly selected into sham operation group （n=4）, ANP model group （model group, n=8） and ANP model with bilateral greater splanchnic nerve blockage group （GSNB group, n=8）. The ANP model was induced by injection of 5% sodium taurocholate and trypsin into the pancreatic duct, and dogs in GSNB group underwent bilateral greater splanchnic nerve transection immediately after ANP induction. After surgery, the serum levels of pancreatic amylase （AMY）, calcium, high-sensitivity C-reactive protein （HCRP）, tumor necrosis factor a （TNF-a） and interleukin 10 （IL-10）were monitored dynamically, and at postoperative day 7, all the animals were sacrificed and the pathological examinations were performed. Results： The results of repeated measures analysis of variance demonstrated that the serum AMY level was significantly increased, calcium level was significantly decreased, and the levels of HCRP, TNF-α and IL-10 were significantly increased in either model group or GSNB group versus sham operation group （all P〈0.01）; no significant difference was noted in AMY level between model group and GSNB group, but the serum levels of HCRP and TNF-α were lower and serum levels of calcium and IL-10 were higher in GSNB group than those in model group （all P〈0.05）. The gross and microscopic pathological findings showed that dogs in both model group and GSNB had typical ANP changes, but the severity of the pathological changes in GSNB group was milder than that of model group.Conclusion： Greater splanchnic nerve transection can alleviate development of pathological process inANP dogs.

关 键 词：胰腺炎 急性坏死性 内脏大神经 应激 

分 类 号：R657.5[医药卫生—外科学]