小肠出血栓塞治疗前后应用血管加压素安全性的研究

目的 探讨小肠出血栓塞治疗前后应用血管加压素（VS）的安全性。材料与方法 健康杂种犬7只,结扎直动脉制作肠栓塞模型。实验肠段总数28段。分A组（n=8),停用VS 30min后栓塞;B组（n=8),停用VS 2h后栓塞;C组（n=8),栓塞后立即应用VS;对照组（n=4),不应用VS。检测应用VS前后、栓塞前后正常肠壁和栓塞肠段肠壁血液pH、PO2,观察血管造影表现。1周后病检。结果 （1）直动脉栓塞后局部pH和PO2迅速下降,对照组及A、B组1h时回升,C组无回升。（2）静滴VS后栓塞区未见侧支供血。（3）病检示A、B组和对照组肠粘膜轻度损伤,C组肠粘膜中度损伤。结论 停用VS 2h后进行小肠出血栓塞治疗,其安全性不会受到影响;栓塞后立即应用VS可加重栓塞肠段的缺血性损伤。

Safety of Vasopression Infusion Performed before and after Embolization Therapy for Small Intestinal Hemorrhage: An Experimental Study

Objective To study the safety of vasopression (VS) infusion performed before and after emboliotherapy for small intestinal hemorrhage.Materials and Methods The vasa recta were isolated and ligated to make intestinal embolic models in 7 dogs. The total experimental intestinal segments were 28, which were divided into 4 groups. Group A (n=8), embolization was performed 30min after VS infusion finished. Group B (n=8), embolization was performed 2 hours after VS infusion finished. Group C (n=8), VS infusion was performed immediately after embolization. Control group (n=4), no VS infusion was used. Both the measurement of blood pH, PO 2 and the angiography of the normal and embolic intestinal wall were performed before and after VS infusion, as well as before and after embolization. The embolic parts were resected a week later and examined pathologically.Results (1) In all groups, the blood pH and PO 2 of the embolic intestinal wall dropped significantly soon after embolization. In an hour, the blood pH and PO 2 rose again in all groups except group C. (2) Contraction of all mesenteric arterial branches was seen after VS infusion, recovered completely in 2 hours after infusion finished. Collateral blood supply developed immediately after embolization in all groups except group C. (3) Pathologically, mild mucosal ischemia was seen in group A, B and control group, while moderate mucosal ischemia in group C. Conclusion VS infusion has no negative effect on the safety of emboliotherapy for small intestinal hemorrhage if the embolization procedure is performed 2 hours after the infusion. VS infusion immediately after embolization may aggravate the ischemic damage of the embolized intestine.