• 作者： 沈國樑
• 作者服務機構： 國防醫學院外科學科; 三軍總醫院外科部
• 中文摘要： 本實驗目的在探討貓經胃小彎胃底肌層切開術後，胃迷走神經的再生狀況。
  控制組，將蒲菜過氧化氫?（HRP）打在兩側胃小彎胃底肌層切開假想線的胃壁上。經過組織化學法確知胃迷走神經
  輸入纖維的神經細胞體位於頸部的結節狀神經節上，而輸出纖維的神經細胞體位於腦幹的迷走神經背運動核上。
  實驗組，將貓分成三小組。A,B,兩小組經胃小彎胃底肌層切開術後，分別在0天，2,4,6,8,10‧及12週進行HRP
  組織化學研究。於A小組，HRP直接打在胃小彎胃底肌層切開面的遠端。於B小組，在打HRP前加行胃體胃竇間環形肌
  層切開術，以排除胃竇幽門部位殘存的迷走神經之側枝增生的可能性，然後再依前法在胃壁上打入HRP。於C小組，直
  接進行胄小彎胃底肌層切開及胃體胃竇間環形肌層切開術並加行胃壁重疊縫合術。12週後，再同A小組股將HRP打入胃
  壁上。
  給果，A,B兩小組第六週在結節狀神經節及第八週在迷走神經背運動核上分別出現含有HRP的細胞。且有隨著時間
  延長而增加的趨勢。但在同一時段A組出現的數目皆比B組者多。於C小組，直到12週未曾見到含有HRP的細胞。
  由此實驗所得結論，胃迷走神經經胃小彎胃底肌層切開術後確實會再生。其機轉可能是神經經斷端端對端的再生，
  或由胃竇幽門餘留下的迷走神經側枝增生而來。經胃小彎胃底肌層切開及胃體胃竇環形肌層切開術加行胃壁重疊縫合術
  可防止胃迷走神經之再生。c
• 英文摘要： The aim of this study was to investigate the reinnveration of gastric vagus nerves after lessercurvature and fundus myotomy (LCFM) in cats. After injection of the retrogradely tracing agent horseradish peroxidase (HRP) into the stomachwall along the predicted line of LCFM, the neuronal cell bodies of the afferent and efferent fibers werewell-defined in both the nodose ganglia (NG) and dorsal motor nucleus of the vagus nerve (DMNx), respec-tively. The animals were divided into three subgroups. After LCFM, at intervals of 0 day, 2,4,6,8,10 and12 weeks, respectively, they were processed for a HRP histochemical study in both subgroups A and B.In subgroup A, HRP was directly injected into both sides of the stomach wall distal to the dissectingplane of LCFM. A further corpoantral circumferential myotomy (CACM) was performed in subgroup Bto eliminate the possibility of collateral sprouting via antropyloric vagus innervation before applyingHRP to the same sites as those of subgroup A. Both LCFM and CACM with an overlapping suture wereperformed in subgroup C, and HRP was then injected into sites similar to those of subgroup A on thetwelfth postoperative week. HRP-labeled cells were found in the NG on the sixth week and in the DMNx on the eighth weekin subgroups A and B. The labeled cells increased in number until the twelfth week in both subgroups Aand B. However, cells found in subgroup A were always more numerous than those found in subgroup Bin both the NG and DMNx at equivalent time intervals. No labeled cell was found in the NG or DMNxin subgroup C during the 12 week study period. We conclude that the gastric vagus nerve after LCFM is able to reinnervate either via the route ofterminal or collateral sprouting of the antropyloric vagus nerves and LCFM and CACM with an overlappingsuture may prevent reinnervation of vagus nerves.
• 中文關鍵字： vagotomy; regeneration; histochemistry
• 英文關鍵字： --