Kasparek Michael S, Mueller Mario H, Glatzle Jörg, Enck Paul, Becker Horst D, Zittel Tilman T, Kreis Martin E
Department of General Surgery, University Hospital Tuebingen, Tuebingen Germany.
Surgery. 2004 Nov;136(5):1019-27. doi: 10.1016/j.surg.2004.03.011.
Stimulation of colonic motility by the gastrocolonic response may help to reduce inhibition of gastrointestinal motility after colorectal surgery. We aimed to investigate whether postoperative colonic motility is increased after early food intake.
Nineteen patients undergoing colorectal surgery and 7 healthy volunteers were investigated. Colonic motility was recorded with a combined manometry/barostat system, and the effect of a standard 500-kcal meal was evaluated once in healthy volunteers and in 15 patients on the first and second postoperative day. Four patients remained unfed, serving as controls.
In patients, the colonic motility index increased from 12 +/- 5 at baseline to 65 +/- 24 mm Hg after the meal on postoperative day 1 (mean +/- SEM; P < .01), while barostat bag volumes decreased, indicating a rise in colonic tone. On day 2, the motility index was 62 +/- 17 mm Hg at baseline and did not change after the meal. In unfed controls, no change was observed during colonic motility recordings on both postoperative days. In healthy volunteers, the colonic motility index increased from 98 +/- 52 at baseline to 151 +/- 58 mm Hg postprandially (P < .05).
As in healthy volunteers, there is a potential to stimulate colonic motility by early food intake in postoperative patients. This may help to improve prolonged colonic motility disorders after colorectal surgery.
胃结肠反射刺激结肠运动可能有助于减轻结直肠手术后胃肠动力的抑制。我们旨在研究早期进食后术后结肠运动是否增强。
对19例接受结直肠手术的患者和7名健康志愿者进行了研究。使用测压/恒压器联合系统记录结肠运动,并在健康志愿者以及15例患者术后第1天和第2天评估一次标准500千卡餐的效果。4例患者未进食,作为对照。
在患者中,结肠运动指数从基线时的12±5增加到术后第1天进食后的65±24 mmHg(平均值±标准误;P<.01),而恒压器气囊容积减小,表明结肠张力增加。在第2天,基线时运动指数为62±17 mmHg,进食后未发生变化。在未进食的对照组中,术后两天结肠运动记录期间均未观察到变化。在健康志愿者中,结肠运动指数从基线时的98±52增加到餐后的151±58 mmHg(P<.05)。
与健康志愿者一样,术后患者早期进食有刺激结肠运动的潜力。这可能有助于改善结直肠手术后长期的结肠运动障碍。