酸素電極法でみた内腸骨動脈結紮時の膀胱壁内循環動態

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The present study was undertaken to determine if internal iliac artery ligation causes changes in the bladder wall circulation sufficient to control hemorrhage by shutting off the blood flow in urologic surgery. Such study is prerequisite for a better understanding of the internal iliac artery ligation widely used as a means of hemostasis in urologic surgery. Twenty-two dogs weighing 7 to 31kg were used in the present study. Dogs were anesthetized with thiamylal-Na and the aorta, the internal iliac artery and the bladder were exposed transperitoneally. One male patient with bladder carcinoma was anesthetized epidurally and his bladder was exposed by a median incision at the lower abdomen. The bladder wall PO_2, an index of blood flow, was continuously measured by the Yagi's polarographic o_2 electrode of an enameled copper wire 300μ in diameter implanted in the muscular layers of bilateral and posterior bladder walls, respectively. In the patient with bladder carcinoma the electrode was implanted in the posterior bladder wall. In four dogs, the electrode was also placed in the abdominal aorta to measure arterical PO_2. Changes in the polarographic amplitudes after artery ligation were expressed as percent of the level obtained before ligation. In the experiments with ligations of internal iliac artery and abdominal aorta ligation, both arterial and bladder wall PO_2 were monitored during 100% O_2 breathing and the increment of the bladder wall PO_2 and the response time to O_2 breathing were measured. The following results were obtained : 1) Before ligation, the bladder wall PO_2 Increased up to 141-174 during O_2 breathing. 2) After internal iliac artery ligation, the bladder wall PO_2 decreased to 76-79% and the PO_2 Increments (28-45) were significantly lower than the control values (41 -74) (P<0.01). The response time to O_2 breathing was significantly greater in the ligation (20-25 sec) than the control (8-10 sec). After ligation PO_2 decreased initially but it showed an increase in 14 out of 46 areas of the bladder later, the mean increment was 11% and it occurred 204 seconds after the ligation on the average.
社団法人日本泌尿器科学会の論文

酸素電極法でみた内腸骨動脈結紮時の膀胱壁内循環動態

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