Jacobs D L, Lof J, Quigley E M, Spanta A D, Rikkers L F
Department of Surgery, University of Nebraska Medical Center, Omaha 68105.
J Surg Res. 1990 Jun;48(6):562-7. doi: 10.1016/0022-4804(90)90231-p.
The effects of portal hypertension on gut function may be mediated by venous congestion and altered circulating levels of enteric hormones and neuropeptides. We designed this study to determine the effects of chronic intestinal venous hypertension (VHT), in isolation, on gut motility and absorption. In 10 dogs, a 20- to 25-cm loop of jejunum was isolated from the fecal stream, but myoneural continuity was maintained with the proximal bowel by a seromuscular bridge. In 5 dogs, VHT was created in the loop by a fixed stenosis of its venous drainage; a sham procedure was performed in a further 5 animals. Serosal monopolar electrodes were placed in all animals. Absorptive function and myoelectrical activity were studied over a 4-week period. Venous hypertension was achieved and sustained in the VHT animals; loop vein pressures for VHT vs control in cm H2O (means +/- SEM) are: initial--29.8 +/- 1.8 vs 7.5 +/- 0.4 (P less than 0.01), and at 4 weeks--17.6 +/- 6.88 vs 7.3 +/- 0.2 (P less than 0.01). Absorption of Na+, Cl-, glucose, and water was impaired in VHT loops. Normal patterns of fasting and postprandial myoelectrical activity were preserved in the VHT animals. We conclude that chronic VHT, in the absence of portosystemic shunting, results in impaired absorption of water, glucose, and electrolytes without any change in intestinal motility.
门静脉高压对肠道功能的影响可能是由静脉充血以及肠内激素和神经肽循环水平的改变介导的。我们设计了这项研究，以确定孤立的慢性肠静脉高压（VHT）对肠道运动和吸收的影响。在10只犬中，将一段20至25厘米的空肠与粪便流隔离，但通过浆肌层桥使其与近端肠段保持肌神经连续性。在5只犬中，通过对其静脉引流进行固定狭窄在肠袢中制造VHT；另外5只动物进行假手术。所有动物均放置浆膜单极电极。在4周的时间内研究吸收功能和肌电活动。VHT组动物实现并维持了静脉高压；VHT组与对照组肠袢静脉压力以厘米水柱计（均值±标准误）分别为：初始时——29.8±1.8 vs 7.5±0.4（P<0.01），4周时——17.6±6.88 vs 7.3±0.2（P<0.01）。VHT组肠袢对Na⁺、Cl⁻、葡萄糖和水的吸收受损。VHT组动物保留了空腹和餐后肌电活动的正常模式。我们得出结论，在没有门体分流的情况下，慢性VHT会导致水、葡萄糖和电解质吸收受损，而肠道运动无任何变化。
