急诊洗胃致胃破裂机理的探讨

Research on the Mechanism of the Rupture of Stomach Caused by Emergency Gastric Lavage

通过对电动洗胃机洗胃致家犬胃破裂的实验观察,就洗胃压、胃内洗胃液容量和胃壁的解剖特点在诱发胃破裂机理中的作用作一初步探讨。结果提示,对照组家犬洗胃压控制在27.0～53.3kPa/cm^2,胃容量超过容受性舒张限度,胃壁平滑肌过度牵张,兴奋性、收缩性和伸展性遭破坏是导致胃破裂的主要原因。家犬经口灌注敌敌畏后,由于肠道平滑肌强直性痉挛。胃容量缩小,输出道梗阻,需较高的洗胃压(46.0～92.kPa/cm^2)才能引发胃破裂。无论高洗胃压、高容量或胃管直接损伤而使胃破裂多发於小弯侧胃壁,与该处胃壁的解剖特点有关。

Mechanism of the experimental rupture of stomach during the use of an electric gastrolavage machine was studied in respect to domestic dog's gastrorupture,the thesis will preliminarily inqure into the mechanism effect the gastrolavage pressure,the capacity of the lavage liquid and the regional anatomy of stomach wall. Results Show:in a health dogif gastrolavage pressure is controlled from 27.0 kPa/cm^2 to 53. 3 kPa/cm^2,the gastric capacity going beyond the limit of gastric relaxation resulting in exces- sive extension with impairment of excitability,contractablilty and extensibilty of gastric leomyoma is the main machanism to cause gastric rupture.After imgestion of DDV,smooth muscle of the gastric walls appear tonic spasm,its resulting in reduced stomach capacity ob- struction to gastric outlet.In such instance,a higher pressure(46.0—72.0kPa/cm^2)is need to induced gastric rupture,irrespective to high introgastric pressure,decrease in or obstruction of capacity or direct injury and the stomach.Rupture frequantly occurred in the lesser curva- ture of stomach,probably due to regional anatomy of stomach wall.