胰管加压对胆、胃 功能的影响

向大鼠胰管内间歇地定时充注生理盐水,使胰管内压逐步增高0.98～3.92kPa(10～40cmH_2O),可引起胆流量明显增多,峰值在加压2.94kPa(30cmH_2O)时,实验还显示胰管加压可使胆汁内重碳酸盐的含量升高和胆汁酸含量降低,以及胃窦峰形放电和胃液分泌增加,但胃酸分泌则无明显改变。如先将两侧膈下迷走神经切断再进行胰管加压,则不出现上述变化,相反地抑制胆汁分泌。如用5％奴弗卡因溶液代替生理盐水作胰管加压时,也呈现类似现象。从而表明:胰管加压引起的胆汁、胃液分泌和胃电增加是一种通过迷走神经的反射效应。胰管内膜存在某种压敏感受器;所引起的胆汁分泌属于胆汁酸非依存性利胆。胰管高压时胆、胃功能变化,特别是对胆胰合流的情况,可能具有适应性抗病意义。

EFFECT OF INTRADUCT PRESSURE RAISED IN PANCREAS ON BILIARY AND GASTRIC FUNCTION

The bile secretion would be increased simultanously and obviously withthe pressure in pancreatic duct raised 0. 98--3. 92kPa (10--40cmH_2O) byintraduct intermittence saline infusion, and the peak value was at 2.94kPa (30cmH_20). The study also demonstrated that the content of bilebicarbonate would be increased and bile acid would be decreased; otherwisethe spike potential of gastric antrum and the secretory volume ofgastric juice would be also increased during the intraduct pressure ofpancreas raised. All the differences of changes mentioned above exceptgastric acid secretion were significant as compared to preoperation.The further study showed that these changes mentioned above woulddisappear after subdiaphragm vagotomy, and conversely the bile secre-tion would be inhibited during pancreatic pressure increased. Thisphenomenon also can be found in intra-pancreatic duct infusion with5% Novocain. Therefore suggested that the increase of bile, gastricjuice secretion and antral spike potential caused by pancreatic ductpressure raise might be a vagovagal response. The pancreatic ductmucous membrane also might contain some pressure sensitive receptors,which could cause the bile acid independent cholepoiesis. The biliaryand gastric functional change during pressure raised in pancreatic ductmight be an adaptive reaction especially in the condition of pancreaticand biliary common duct.