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[化学性腹膜炎继发麻痹性肠梗阻的病理生理学。犬的实验研究]

[Physiopathology of paralytic ileus secondary to chemical peritonitis. Experimental study in dogs].

作者信息

García Olmo D, Esteban Redondo E, Pellicer Franco E, Hita Villaplana G, Mompeán Morales B, Canteras Jordana M, Parrilla Paricio P

出版信息

Rev Esp Enferm Apar Dig. 1989 Oct;76(4):307-15.

PMID:2687974
Abstract

The intestinal paralysis that follows peritonitis has been classically explained as the result of local inflammation of the overlying serosa (Stokes's law). The main object of this study is to determine if these motor alterations, the most relevant of them being intestinal paralysis, are really due to local factors or to general factors in view of the intense affectation that peritonitis induces in the organism. For this purpose we used animals with an isolated and exteriorized intestinal loop to study loop motility during peritonitis in the absence of direct local contact with the process. To test the operation of the smooth intestinal muscle and intrinsic plexus we used two types of motor stimuli: hormonal (insulin) and pure (prostigmine). We found that the isolated loop presented the normal motor characteristics of the small intestine. When peritonitis was achieved, all motor activity ceased in the intracavitary loops and in the isolated loops exposed to acid, so all the intestinal segments were completely paralyzed. The administration of insulin under these circumstances only had effect on the exteriorized loop, where we recorded motor activity similar to that of normal conditions. The administration of prostigmine caused the appearance of a sharp, synchronic contraction of the three intestinal segments studied. Based on these findings, we conclude that the smooth fiber of the small intestine is not paralyzed during peritonitis and can exhibit intense contraction when the motor plate is stimulated with prostigmine.(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

腹膜炎后出现的肠麻痹传统上被解释为覆盖其上的浆膜局部炎症的结果(斯托克斯定律)。本研究的主要目的是,鉴于腹膜炎对机体造成的强烈影响,确定这些运动改变,其中最相关的是肠麻痹,究竟是由局部因素还是全身因素引起的。为此,我们使用了肠袢分离并外置的动物,以研究在不与腹膜炎过程直接局部接触的情况下肠袢在腹膜炎期间的运动。为了测试肠道平滑肌和内在神经丛的运作,我们使用了两种类型的运动刺激:激素(胰岛素)和纯药物(新斯的明)。我们发现分离的肠袢呈现出小肠正常的运动特征。当诱发腹膜炎时,腔内肠袢以及暴露于酸性环境的分离肠袢的所有运动活动均停止,因此所有肠段完全麻痹。在这些情况下给予胰岛素仅对外置肠袢有影响,我们在那里记录到与正常情况相似的运动活动。给予新斯的明会导致所研究的三个肠段出现急剧、同步的收缩。基于这些发现,我们得出结论,在腹膜炎期间小肠的平滑肌并未麻痹,并且在用新斯的明刺激运动终板时可表现出强烈收缩。(摘要截短为250字)

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