Miholic J, Vogelsang H, Schlappack O, Kletter K, Szepesi T, Moeschl P
II. Chirurgische Klinik, Universität Wien, Osterreich.
Digestion. 1989;42(1):30-8. doi: 10.1159/000199822.
The retention of the gamma-emitting 75Se-homotaurocholic acid (SeHCAT) after 72 and 168 h was assessed in 10 patients after ileal resection for radiation injury (group I). 6 patients suffering from chronic postirradiation diarrhea (group II) and 6 patients in whom the ileum had been resected for other indications (group III) were also examined. The retention of SeHCAT was abnormally low (less than 50%) in all cases after 72 h and below 20% in 19 out of 21 cases after 168 h. The length of resected small bowel (groups I and III) was inversely related with SeHCAT retention after 72 h (r = 0.63; p = 0.015), but not after 168 h. There was no correlation between the diarrhea score and the extent of bowel resection, SeHCAT retention or xylose absorption. Hydrogen breath test with lactulose revealed a significantly shortened orocecal transit time in group I, compared to groups II and III. Xylose absorption was significantly reduced in patients with positive 5 g xylose-H2 breath test. In groups I and III, however, xylose absorption tended to improve with increasing time interval following resection (r = 0.79; p = 0.003). It is concluded that radiation injury in addition to small-bowel resection contributes significantly to malabsorption and diarrhea in patients after ileal resection for radiation sequelae. The chronic radiation damage seems to act mainly through impaired motility.
对10例因放射性损伤行回肠切除术后的患者（第一组），评估了75硒-同型牛磺胆酸（SeHCAT）在72小时和168小时后的潴留情况。还对6例患有慢性放射性腹泻的患者（第二组）和6例因其他指征行回肠切除术的患者（第三组）进行了检查。在所有病例中，72小时后SeHCAT的潴留异常低（低于50%），21例中有19例在168小时后低于20%。切除的小肠长度（第一组和第三组）与72小时后SeHCAT的潴留呈负相关（r = 0.63；p = 0.015），但168小时后无此相关性。腹泻评分与肠切除范围、SeHCAT潴留或木糖吸收之间无相关性。与第二组和第三组相比，第一组用乳果糖进行的氢呼气试验显示口盲传输时间显著缩短。5克木糖-H2呼气试验阳性的患者木糖吸收显著降低。然而，在第一组和第三组中，木糖吸收倾向于随着切除后时间间隔的增加而改善（r = 0.79；p = 0.003）。得出的结论是，除小肠切除外，放射性损伤对因放射性后遗症行回肠切除术后患者的吸收不良和腹泻有显著影响。慢性放射性损伤似乎主要通过运动功能受损起作用。
