Miedema B W, Karlstrom L, Hanson R B, Johnson G P, Kelly K A
Digestive Disease Center, Mayo Clinic, Rochester, Minnesota 55905.
Dis Colon Rectum. 1990 Oct;33(10):829-35. doi: 10.1007/BF02051917.
The authors assessed absorption and motility of the human ileum after a prolonged period of disuse. In eight patients with ulcerative colitis, a manometric-catheter assembly was placed via the ileostomy into the unused portion of distal ileum two months after ileal pouch-anal anastomosis and temporary diverting loop ileostomy. The distal ileum was perfused at 5 ml/min with an isosmotic solution of either sodium chloride or ileal chyme diluted with sodium chloride for three hours before and three hours after a meal on two consecutive days. Absorption was measured, single and clustered pressure waves were identified and quantitated with the aid of a computer program, and a motility index was calculated. Mean absorption +/- S.E.M. of both perfusates was poor on day 1 (-10 +/- 2 ml/25 cm x 30 min), and the meal induced no ileal motor response. By day 2, however, absorption of both perfusates was much improved (-1 +/- 2 ml/25 cm x 30 min; P less than 0.05), and the number of discrete clustered contractions and the motility index now clearly increased after the meal (2.6 +/- 0.6 vs. 7.2 +/- 1.0 clustered waves/hr; 7.5 +/- 0.5 vs. 9.7 +/- 0.2 motility units/30 min; P less than 0.05). The conclusion was that absorption and motility of the human ileum were impaired after two months of disuse, but that ileal absorption and motility improved one day after the introduction of isosmotic ileal perfusates.
作者评估了长期废用后人回肠的吸收和运动情况。在8例溃疡性结肠炎患者中，回肠储袋肛管吻合术及临时性转流襻回肠造口术后两个月，通过回肠造口将测压导管组件置入末段回肠的未使用部分。连续两天，在餐前3小时和餐后3小时，以5毫升/分钟的速度用氯化钠等渗溶液或用氯化钠稀释的回肠食糜灌注末段回肠。测量吸收情况，借助计算机程序识别并定量单个和成群的压力波，并计算运动指数。第1天，两种灌注液的平均吸收量±标准误均较差（-10±2毫升/25厘米×30分钟），进餐未引起回肠运动反应。然而，到第2天，两种灌注液的吸收均有显著改善（-1±2毫升/25厘米×30分钟；P<0.05），餐后离散成群收缩的次数和运动指数明显增加（2.6±0.6对7.2±1.0次成群波/小时；7.5±0.5对9.7±0.2运动单位/30分钟；P<0.05）。结论是，人回肠在废用两个月后吸收和运动受损，但在引入等渗回肠灌注液一天后回肠吸收和运动有所改善。
