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find Keyword "迷走神经" 32 results
  • Gastric Function after Esophagectomy with Vagus Preserved

    ObjectiveTo study the gastric function of vagus-preserved patients after esophagectomy, and to evaluate the significance of keeping vagus and the value of gastric tube with vagal-sparing esophagectomy. MethodsWe retrospectively analyzed clinical data of 15 patients in West China Hospital between June 2012 and January 2014. They were divided into two groups. There were 8 patients with 6 males and 2 females with average age of 57 years ranging from 44 to 77 years, in a gastric pull-up group with vagal-sparing esophagectomy. There were 7 patients with 6 males and 1 female at average age of 60 years ranging from 50 to 70 years in a gastric tube group with vagal-sparing esophagectomy. We chose 8 patients with 7 males and 1 female at average age of 62 years ranging from 47 to 69 years as a control group with a classical esophagectomy and a gastric pull-up. Then we evaluated the function of the vagal nerves and gastric reservoir after vagal-sparing esophagectomy. ResultsAll 23 surgeries were successfully performed. In subjective symptom, diarrhea was rare in the vagal-sparing esophagectomy patients and statistically more common in patients with a standard esophagectomy. Dumping and early satisfaction situation were similar among 3 groups. The 60 minutes gastric emptying rate was much better in the vagal-sparing group than that in the control group. And the esophageal manometry of the vagal-sparing group was statistically hihger than that in the control group. The gastroscope showed that the incidence of reflux esophagitis in the vagal-sparing group was statistically lower than that of the control group. There was no statistic difference in weight in the vagus-preserved group before and after the surgery while the weight decreased statistically in the control group. ConclusionsFor both esophageal replacement and gastric tube, preserving the vagus can reduce the functional dyspepsia after esophagectomy.

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  • The Effect of Highly Selective Vagotomy Plus Mucosal Antrectomy and Highly Selective Vagotomy Alone on Motor Function of Gastric Antrum

    Objective To investigate the effects of highly selective vagotomy plus mucosal antrectomy (HSVMA) and highly selective vagotomy (HSV) alone on the functions of the gastric antrum. MethodsEighteen dogs and 48 patients with chronic duodenal ulcer were tested. The time of gastric emptying, antral myoelectric activity, antral pressure were measured 4-6 months after operation in 18 dogs which were randomized into the control, HSV and HSVMA groups. The gastric evacuation, frequency and amplitude of electrogastrography (EGG) were observed 4-6 months after operation in 48 patients who were randomly divided into HSV (20 patients) and HSVMA (28 patients) group, their preoperative values were considered as control group. ResultsIt was found by barium meal examinations that the shape of the stomach and duodenum was normal and gastric peristalsis was clearly visible in all the animals and patients of two postoperative groups. The beginning and ending time of gastric emptying were (5.0±0.06) min and (4.0±0.4) h respectively in the dogs of HSVMA group, which were similar to those of the dogs of control and HSV group (Pgt;0.05). The frequency of the antral myoelectric action potential was (3.11±0.65 ) cycles/min in the dogs of HSVMA group, the frequency of EGG was (3.25±0.75) cycles/min in the patients of HSVMA group, which were significantly lower than that of the dogs or patients of control and HSV group (P<0.05). Injection of pentagastrin in dogs or taking meal in patients significantly increased the antral pressure or amplitude of EGG. Conclusion The motor function of the reconstructed antrum in the HSVMA group approaches the normal level despite a lower antral myoelectric frequency. It is believed that HSVMA will be a choice for the treatment of duodenal ulcer.

    Release date:2016-08-28 05:10 Export PDF Favorites Scan
  • 贲门周围血管离断加胃底折叠钉合术治疗门脉高压症27例报告

    Release date:2016-08-29 09:18 Export PDF Favorites Scan
  • EFFECT OF HIGHLY SELECTIVE VAGOTOMY AND MUCOSAL ANTRECTOMY ON ELECTROGASTROGRAPHY

    To observe the changes of antral motor function and electrogastrography of 12 dogs and 30 patients with duodenal ulcer after highly selective vagotomy and mucosal antrectomy.Results: in an empty stomach, the preoperative and postoperative antral pressure value of dogs was similar, but the antral action potential frequency of dogs was slower after operation than that before operation. After injection of pentagastrin, whether before or after operation, the antral pressure value and action potential frequency of dogs were similar in the two groups. In an empty stomach, the electrogastrography frequency of patietns with duodenal ulcer was decreased after operation than that before operation, but their value of electrogastrography was similar, and after taking food, their preoperative and postoperative value and frequency of electrogastrography were significantly higher than that before taking food. But, whether before or after operation, there wasn’t significant diffence in them.Conclusions: there wasn’t changes of antral motor function and electrogastrography in dogs and patients with duodenal ulcer after highly selective vagotomy and mucosal antrectomy.

    Release date:2016-08-29 03:19 Export PDF Favorites Scan
  • HIGHLY SELECTIVE VAGOTOMY FOR THE TREATMENT OF DUODENAL ULCER(REPORT OF 217 CASES)

    Modified Goligher’s highly selective vagotomy (HSV) for 217 cases of duodenal ulcers is reported. In this series they were: duodenal ulcer (100 cases), combined gastric and duodenal ulcers (79 cases) and complicated perforating, bleeding or stenosed ulcers (38 cases). In the complicated duodenal ulcer, HSV was usually carried out with suturing bleeding point, perforated ulcer or with pyloroplasty. With a follow-up of 3~20 years, the recurrence rate werelt;2% and 85.7% of cases had excellent or good results as Visick classification. Considerations relevant to the HSV technic are deemed worthy of emphasis; complete resection of gastric branches of anterior and posterior vagal trunks and preservation of the first limb of the "Crow’s foot", extended dissection of the distal 5-7cm of the esophagus and division of the distal 8-10cm of the bundle of the gastroepiploic vessels in order to deprive the whole parietal cell mass of its vagal supply. In 4 patients, recurrence were easily controlled with remedies or operation for gastric retention by rational type. The authors suggest that the modified HSV plus mucusdeprived antrectomy be the rational surgical choice for duodenal ulcer.

    Release date:2016-08-29 03:26 Export PDF Favorites Scan
  • GROSS AND HISTOLOGICAL OBSERVATIONS OF DOG’S STOMACH AFTER HIGHLY SELECTIVE VAGOTOMY AND MUCOSAL ANTRECTOMY

    Six dogs underwent high selective vagotomy and mucosal antrectomy (HSV+MA). The gross and histological change of dog’s stomach were observed at 4-6 months after operation. It was found that the reconstructed antrum healed well and there was no stasis and distension in the stomach .The appearance of the nerves in muscular layer of the antrum was normal. No serious gastritis and mucosal atrophy was observed. These results indicat that HSV+MA is a reasonable procedure for the treatment of duodenal ulcer.

    Release date:2016-08-29 03:44 Export PDF Favorites Scan
  • THE EFFECT OF HIGHLY SELECTIVE VAGOTOMY AND MUCOSAL ANTRECTOMY ON SERUM GASTRIN AND GASTRIC EMPTYING

    Forty-two patients with duodenal ulcer underwent highly selective vagotomy and mucosal antrectomy (HSV+MA) and were followed up for 3 years. Two weeks, 1 year and 3 year after operation, serum gastrim level and gastric emptying capacity were tested. The results show that he postoperative levels of serum gastrin were lower than the preoperative ones, but wih no significant difference (P>0.05). Only a few patients had delayed gastric emptying 2 weeks and 1year after operation,but it returned to normal in 3 years .The authors conclude that HSV+MA is a better operative treatment for duodenal ulcer since it can abolish the factors of postoperative ulcer recurence and perserve the functions of the antrum and the pylorus.

    Release date:2016-08-29 03:44 Export PDF Favorites Scan
  • 贲门癌手术对胆囊收缩功能的影响

    目的 研究贲门癌患者围手术期对胆囊功能的影响,减少术后消化道并发症。方法 将82例贲门癌患者按手术中是否保留迷走神经,分为两组,Ⅰ组(n=65): 手术中未保留迷走神经;Ⅱ组(n=17): 手术中保留迷走神经。用B型超声波测量胆囊容积、胆囊收缩功能,并进行手术前后自身对照和两种术式的对比研究。结果 Ⅰ组胆囊容积、收缩功能术前与术后比较差别具有显著性意义(P<0.01),Ⅱ组改变不明显(P>0.05);术后胆囊容积两组比较差别具有显著性意义(P<0.01);Ⅰ组患者术后消化道症状明显,胆囊结石发生明显增多。结论 保留迷走神经干的贲门癌切除术有利于患者术后的胆囊功能恢复和提高生活质量。

    Release date:2016-08-30 06:34 Export PDF Favorites Scan
  • EXPERIMENTAL STUDY ON PROMOTION OF SOMATO-VISCERAL HETEROGENIC REINNERVATION WITH NERVE GROWTH FACTOR IN RAT PHRENIC-TO-VAGUS ANASTOMOSIS MODEL

    Objective To investigate the influence of nerve growth factor (NGF) on neuroal regeneration of somatovisceral heterogenic reinnervation using a rat phrenic-to-vagus anastomosis model. Methods Forty male SD rats, aging 3 months and weighing 200 g, were selected and randomly divided into 3 groups. In group A (n=10, control group), phrenic and vagusnerves were exposed and no neurorraphy was performed. In group B (n=15) and group C (n=15), both nerves were transected and proximal stump of phrenic nevers were microsurgically anastomosed to the distal stump of vagus nerves. Postoperatively, group C was intraperitoneally injected with NGF (20 μg/kg·d), while groups A and B were given matching sal ine solution. Twelve weeks later, cardiac function was examined under electrical stimulation of the regenerated nerve. Light and electron microscopies were used to examine the heterogenic regenerated nerve, and the passing rate of axon and thickness of myel in sheath were calculated. Results Under electrical never stimulation in groups A, B, and C, the decreases of blood pressure were (20.12 ± 2.57), (10.63 ± 2.44), and (14.18 ± 2.93) mmHg (1 mmHg=0.133 kPa), respectively; and the decreases of heart rate were (66.77 ± 9.96), (33.44 ± 11.82), and (43.27 ± 11.02)/minutes, respectively. In group B, the decrease ampl itudes of blood pressure and heart rate were 52.83% and50.08% of group A, respectively. Blood pressure and heart rate in group C also decreased dramatically; the decrease ampl itudes of blood pressure and heart rate in group C were 70.48% and 64.80% of group A. There were significant differences in the decrease ampl itudes of blood pressure and heart rate (P lt; 0.05) between group B and group C. Morphological observation showed that heterogenic nerve fibers had the structure of matured myel in sheath and their axons could regenerate into the vagus nerve. In group B and group C, the passing rates of axon were 66.83% ± 4.46% and 81.63% ± 3.56%, respectively; and the thicknesses of myel in sheath were (0.25 ± 0.10) μm and (0.46 ± 0.08) μm, respectively; showing significant differences (P lt; 0.05) between group B and group C. Conclusion Heterogenic nerve is primarily a somatic motor nerve; NGF can promote the axons of heterogenic nerve to regenerate into the parasympathetic nerve.

    Release date:2016-08-31 05:48 Export PDF Favorites Scan
  • 超声引导下穿刺术并发血管迷走神经性晕厥的护理

    目的 探讨超声引导下穿刺术后并发血管迷走神经性晕厥患者的护理方法及要点。 方法 对2011年7月-2012年6月32例血管迷走神经性晕厥患者进行严密观察,并针对血管迷走神经性晕厥发生的相关因素采取积极的应对护理措施。 结果 所有患者经过及时正确的处理后生命体征恢复稳定。 结论 及时观察、早期发现及早期处理是超声引导下穿刺致血管迷走神经性晕厥并发症护理的正确原则。

    Release date:2016-09-07 02:37 Export PDF Favorites Scan
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