Kaji Tatsuru, Takamatsu Hideo, Kajiya Hiroshi
Department of Pediatric Surgery, Faculty of Medicine, Kagoshima University, Japan.
JPEN J Parenter Enteral Nutr. 2002 May-Jun;26(3):198-204. doi: 10.1177/0148607102026003198.
The motility of the gastrointestinal tract during total parenteral nutrition (TPN) remains poorly understood. The objective of this study was to determine the motility pattern not only in the gastrointestinal tract but also in the gallbladders of dogs maintained by TPN.
Central venous catheters were inserted through the external jugular vein of 5 dogs and 6 strain gauge force transducers were sewn to the stomach, small intestine, and gallbladder. Two weeks later, oral food was discontinued and motility was recorded for 24 hours after the first migrating motor complex (MMC) was confirmed in the stomach as pre-TPN. TPN was started and continued for 4 weeks, and patterns of motor activity during TPN were recorded for 24 hours at the end of each week.
The durations of MMC in the stomach, duodenum, and gallbladder in pre-TPN were 118 +/- 3 minutes, 118 +/- 2 minutes, and 118 +/- 2 minutes, respectively, but in the first week of TPN they were 432 +/- 56 minutes, 431 +/- 56 minutes, and 386 +/- 29 minutes, respectively. TPN times were significantly longer than those of pre-TPN (corrected p < .005). The durations of MMC in jejunoileum did not alter between pre-TPN and TPN. The occurrences of phase III in the stomach, duodenum, and gallbladder in pre-TPN were 12/d, but during TPN they were reduced significantly (corrected p < .005).
TPN did not affect the motility of the jejunoileum but did inhibit the motor activities of the stomach, duodenum, and gallbladder. The inhibition of gallbladder contraction observed during TPN may be one of the factors inducing gallbladder disease.
全胃肠外营养(TPN)期间胃肠道的运动情况仍知之甚少。本研究的目的是确定TPN维持下犬的胃肠道以及胆囊的运动模式。
通过5只犬的颈外静脉插入中心静脉导管,并将6个应变片式力传感器缝于胃、小肠和胆囊。两周后,停止经口进食,在胃中确认首次移行性运动复合波(MMC)后,记录24小时的运动情况作为TPN前的对照。开始TPN并持续4周,在每周结束时记录TPN期间24小时的运动活动模式。
TPN前胃、十二指肠和胆囊的MMC持续时间分别为118±3分钟、118±2分钟和118±2分钟,但在TPN的第一周分别为432±56分钟、431±56分钟和386±29分钟。TPN期间的时间明显长于TPN前(校正p<.005)。空肠回肠的MMC持续时间在TPN前后没有改变。TPN前胃、十二指肠和胆囊的Ⅲ相出现次数为12次/天,但在TPN期间显著减少(校正p<.005)。
TPN不影响空肠回肠的运动,但确实抑制了胃、十二指肠和胆囊的运动活动。TPN期间观察到的胆囊收缩抑制可能是诱发胆囊疾病的因素之一。