The condition of acute cholangitis of severe type (ACST) develops very rapidly and the prognosis is poor. The main clinical feature is that there is an obvious dynamic variation, which is the principal factor for the ...The condition of acute cholangitis of severe type (ACST) develops very rapidly and the prognosis is poor. The main clinical feature is that there is an obvious dynamic variation, which is the principal factor for the early occurrence of shock and death. In this study the Japanese long ear rabbits were used and biliary tract pressure increasing and splanchnic nervous plexus blocking experiments were conducted. Our results indicate that 0.6% of lidocaine can be used to block the right celiac plexus. It can avoid the decrease of blood pressure due to the pressure increase of the binary tract, and the decrease of blood pressure due to the pressure increase of the binary tract can be corrected by local anesthesia. 8 cases in conformity with the ACST diagnostic standards received the right renal capsule block injection for the purpose of stopping the celiac plexus, 6 cases of whom had a return of blood pressure to various extent, suggesting that the splanchnic nervous activity in the occurrence of ACST is of great significance. The technique may provide a new approach for the clinical treatment of ACST.展开更多
In order to explore the mechanism of hemodynamic changes caused by high binary tract pressure, we established an animal model of high binary tract pressure, in which the disturbance of hemodynamics developed. The cerv...In order to explore the mechanism of hemodynamic changes caused by high binary tract pressure, we established an animal model of high binary tract pressure, in which the disturbance of hemodynamics developed. The cervical or abdominal vague nerve was then blocked. It was observed that when the binary tract pressure was increased to 16 kpa and kept for 1h, the arterial blood pressure and cardiac output decreased immediately and parallelly (P<0. 05). When the cervical or abdominal vague nerve were blocked or the pressure of the binary tract was decreased to zero, both indices returned to normal immediately (P>0. 05). The change of cardiac output lags a little behind that of arterial blood pressure. It suggests that the signal of binary tract pressure increase can be sent to the cardiovascular center through vague nerve, and the balance between sympathic and parasympathic nerve was broken, which led to the weakening of cardiac contraction and decrease of cardiac output. Due to the peripheral effects of vague nerve, hemodynamic resistance of vessels decreased, which brought about redistribution of peripheral blood flow. Both were the causes of hemodynamic disturbances. After the blood pressure decreased markedly, it showed a jump to normal state when cervical vague nerve was blocked. And the amplitude of diastolic blood pressure restored more than that of systolic blood pressure. This suggests that the cardiac output and peripheral blood resistance are important factors that cause the decrease of blood pressure.展开更多
In this study 12 Japanese long ear rabbits were used as models of acute cholangitis of severe type (ACST), and also an increasing pressure apparatus of selfmade caecus to form high pressure of the biliary tract. The a...In this study 12 Japanese long ear rabbits were used as models of acute cholangitis of severe type (ACST), and also an increasing pressure apparatus of selfmade caecus to form high pressure of the biliary tract. The animals were observed for changes in blood dynamics in an attempt to explore the effect and relation of high pressure of biliary tract and infective element in pathogenesis of ACST. It was found that when the biliary pressure was increased within 120 min in the 20 kpa group,the blood endotoxin level showed no obvious increment (P>0.05),but the decreased range of average MAP (mean artery pressure) was over 4 kpa,and the cardiac output also decreased evidently (P<0. 05) , and that when the biliary pressure was decreased,MAP and cardiac output were restored to normal gradually. Of these animals 3 didn't restore their normal condition when the blood pressure decreased to zero and died finally.Meanwhile the electric discharge frequency of the right greater splanchnic nerves increased (P<0.05),but when pressure was reduced, the frequency slowed down. From the above findings,the authors came to the conclusion that the rapid increase of the biliary tract pressure is the important factor leading to a decrease in blood pressure of ACST,and even bringing about irreversible shock , which is involved in the activity of splanchnic nerves.展开更多
文摘The condition of acute cholangitis of severe type (ACST) develops very rapidly and the prognosis is poor. The main clinical feature is that there is an obvious dynamic variation, which is the principal factor for the early occurrence of shock and death. In this study the Japanese long ear rabbits were used and biliary tract pressure increasing and splanchnic nervous plexus blocking experiments were conducted. Our results indicate that 0.6% of lidocaine can be used to block the right celiac plexus. It can avoid the decrease of blood pressure due to the pressure increase of the binary tract, and the decrease of blood pressure due to the pressure increase of the binary tract can be corrected by local anesthesia. 8 cases in conformity with the ACST diagnostic standards received the right renal capsule block injection for the purpose of stopping the celiac plexus, 6 cases of whom had a return of blood pressure to various extent, suggesting that the splanchnic nervous activity in the occurrence of ACST is of great significance. The technique may provide a new approach for the clinical treatment of ACST.
文摘In order to explore the mechanism of hemodynamic changes caused by high binary tract pressure, we established an animal model of high binary tract pressure, in which the disturbance of hemodynamics developed. The cervical or abdominal vague nerve was then blocked. It was observed that when the binary tract pressure was increased to 16 kpa and kept for 1h, the arterial blood pressure and cardiac output decreased immediately and parallelly (P<0. 05). When the cervical or abdominal vague nerve were blocked or the pressure of the binary tract was decreased to zero, both indices returned to normal immediately (P>0. 05). The change of cardiac output lags a little behind that of arterial blood pressure. It suggests that the signal of binary tract pressure increase can be sent to the cardiovascular center through vague nerve, and the balance between sympathic and parasympathic nerve was broken, which led to the weakening of cardiac contraction and decrease of cardiac output. Due to the peripheral effects of vague nerve, hemodynamic resistance of vessels decreased, which brought about redistribution of peripheral blood flow. Both were the causes of hemodynamic disturbances. After the blood pressure decreased markedly, it showed a jump to normal state when cervical vague nerve was blocked. And the amplitude of diastolic blood pressure restored more than that of systolic blood pressure. This suggests that the cardiac output and peripheral blood resistance are important factors that cause the decrease of blood pressure.
文摘In this study 12 Japanese long ear rabbits were used as models of acute cholangitis of severe type (ACST), and also an increasing pressure apparatus of selfmade caecus to form high pressure of the biliary tract. The animals were observed for changes in blood dynamics in an attempt to explore the effect and relation of high pressure of biliary tract and infective element in pathogenesis of ACST. It was found that when the biliary pressure was increased within 120 min in the 20 kpa group,the blood endotoxin level showed no obvious increment (P>0.05),but the decreased range of average MAP (mean artery pressure) was over 4 kpa,and the cardiac output also decreased evidently (P<0. 05) , and that when the biliary pressure was decreased,MAP and cardiac output were restored to normal gradually. Of these animals 3 didn't restore their normal condition when the blood pressure decreased to zero and died finally.Meanwhile the electric discharge frequency of the right greater splanchnic nerves increased (P<0.05),but when pressure was reduced, the frequency slowed down. From the above findings,the authors came to the conclusion that the rapid increase of the biliary tract pressure is the important factor leading to a decrease in blood pressure of ACST,and even bringing about irreversible shock , which is involved in the activity of splanchnic nerves.
