胆囊痛牵涉区的定位

THE INVESTIGATION ABOUT THE REFERRED AREA OF GALLBLADDER PAIN

目的 :根据由胆囊机械扩张刺激和化学性刺激引起血浆外渗出现的部位 ,确定胆囊痛的牵涉区。方法 :先经家兔胆囊底部放置导管。静脉注入伊文斯蓝 ,待其在血浆中均匀分布后分组实验 ,观察皮肤渗出斑并同时记录动物呼吸和心率的变化 ,测量皮肤渗出斑内染料的含量。结果 :动物在机械扩张胆囊和化学刺激胆囊时呼吸加快和心率增加 ,血浆外渗所致的伊文斯蓝渗出点主要集中在肩胛间区 ,且该区皮内染料含量明显高于其他部位 (P <0 .0 1)。结论 :胆囊伤害性刺激可以使肩胛间区皮肤出现明显的血浆外渗 ,推测该部位可能是胆囊痛的牵涉区。

Objective:To investigate the referred area of gallbladder pain according to the plasma extravasation caused by the noxious stimuli to gallbladder. Methods:To develop a model of gallbladder noxious stimuli in rabbits. Rabbits underwent the operation with the cystic duct dissected free of connective tissue and nerves, then ligated. A small incision was made in the fundus and a double-barrel polyethylene cannula inserted and tied in place. The rabbits were randomly assigned into three groups after three days from the survey. The mechanical distension stimulus or chemical stimulus were given after Evans blue dye was distributed in the plasma, then the plasma extravasation was observed and the content was measured, the heart rates and respiratory rates were recorded simultaneously. Results:The mechanical distension stimulus or chemical stimulus both lead to the increment of the heart rates and respiratory rates, the plaque or spots of Evans blue dye by the plasma extravasation were collectively located in the area between the scapulas and the content of Evans blue dye were higher than the controlled group( P <0.01). Conclusion:The noxious stimuli to gallbladder cause the plasma extravasation in the area between the scapulas, this area may be the referred area of gallbladder pain.