Division of Pediatric Surgery, St Louis Children's Hospital, Department of Surgery, Washington University School of Medicine, St Louis, MO 63110, USA.
J Pediatr Surg. 2012 Jun;47(6):1143-9. doi: 10.1016/j.jpedsurg.2012.03.020.
Massive small bowel resection (SBR) results in villus angiogenesis and a critical adaptation response within the remnant bowel. Previous ex vivo studies of intestinal blood flow after SBR are conflicting. We sought to determine the effect of SBR on intestinal hemodynamics using photoacoustic microscopy, a noninvasive, label-free, high-resolution in vivo hybrid imaging modality.
Photoacoustic microscopy was used to image the intestine microvascular system and measure blood flow and oxygen saturation (So(2)) of the terminal mesenteric arteriole and accompanying vein in C57BL6 mice (n = 7) before and immediately after a 50% proximal SBR. A P value of less than .05 was considered significant.
Before SBR, arterial and venous So(2) were similar. Immediately after SBR, the venous So(2) decreased with an increase in the oxygen extraction fraction. In addition, the arterial and venous blood flow significantly decreased.
Massive SBR results in an immediate reduction in intestinal blood flow and increase in tissue oxygen utilization. These physiologic changes are observed throughout the remnant small intestine. The contribution of these early hemodynamic alterations may contribute to the induction of villus angiogenesis and the pathogenesis of normal intestinal adaptation responses.
小肠大量切除术(SBR)可导致绒毛血管生成和残留肠内的关键适应反应。先前关于 SBR 后肠道血流的离体研究结果存在矛盾。我们试图使用光声显微镜来确定 SBR 对肠道血液动力学的影响,光声显微镜是一种非侵入性、无标记、高分辨率的体内混合成像方式。
使用光声显微镜对 C57BL6 小鼠(n=7)的肠微血管系统进行成像,并在 SBR 前和 SBR 后立即测量终末肠系膜小动脉及其伴随静脉的血流和氧饱和度(So(2))。P 值小于 0.05 被认为具有统计学意义。
在 SBR 之前,动脉和静脉 So(2)相似。SBR 后,静脉 So(2)降低,氧提取分数增加。此外,动脉和静脉血流明显减少。
大量 SBR 可导致肠道血流立即减少和组织氧利用增加。这些生理变化在整个残留小肠中都观察到。这些早期血液动力学改变的贡献可能有助于诱导绒毛血管生成和正常肠道适应反应的发病机制。