Allen P I, Gourevitch D, Goldman M
East Birmingham Hospital, UK.
Br J Surg. 1987 Nov;74(11):1053-5. doi: 10.1002/bjs.1800741131.
Changes in mucosal blood flow may occur in many gastrointestinal disorders, but assessment is impossible without a non-invasive in vivo technique. We have compared endoscopic laser Doppler (LD) with oxygen electrode (OE) measurements in a dog isolated colon preparation, using variable perfusion measured with an electromagnetic flow probe. At maximum flow, LD measurements were made at three sites to compare mucosal with serosal readings. Flow rate was varied (1-38 ml/min) and measurements of microcirculatory flux obtained using LD, and of oxygen tension using a serosal OE. A progressive trend towards increasing flux was demonstrated from caecum to rectum-serosa: 46.8 +/- 18.7 V (caecum), 52.6 +/- 17.9 V (mid-colon) and 61.3 +/- 17.6 V (rectum). A parallel trend was observed in mucosal values: 41.1 +/- 18.2 V (caecum), 45.7 +/- 15.2 V (mid-colon) and 54.1 +/- 15.1 V (rectum). At all sites, serosal and mucosal values were not significantly different (Student's t test). LD serosal values correlated significantly with EM flow (r = 0.544, 0.01 greater than P greater than 0.001). A similar linear correlation was found between OE and EM flow (r = 0.65, P less than 0.001). Oxygen tension measurements varied as expected with microcirculatory flux (r = 0.441, 0.02 greater than P greater than 0.01). Endoscopic LD assessment of colonic microcirculation accurately reflects changes in blood flow.
许多胃肠道疾病都可能发生黏膜血流变化,但如果没有非侵入性的体内技术,就无法进行评估。我们在狗的离体结肠标本中,使用电磁流量探头测量可变灌注,比较了内镜激光多普勒(LD)与氧电极(OE)测量结果。在最大流量时,在三个部位进行LD测量,以比较黏膜和浆膜读数。改变流速(1 - 38毫升/分钟),使用LD获得微循环通量测量值,使用浆膜OE获得氧分压测量值。从盲肠到直肠浆膜,通量呈逐渐增加趋势:46.8±18.7 V(盲肠)、52.6±17.9 V(结肠中部)和61.3±17.6 V(直肠)。黏膜值也观察到类似趋势:41.1±18.2 V(盲肠)、45.7±15.2 V(结肠中部)和54.1±15.1 V(直肠)。在所有部位,浆膜和黏膜值无显著差异(学生t检验)。LD浆膜值与电磁流量显著相关(r = 0.544,0.01>P>0.001)。在OE和电磁流量之间也发现了类似的线性相关性(r = 0.65,P<0.001)。氧分压测量值随微循环通量呈预期变化(r = 0.441,0.02>P>0.01)。内镜LD评估结肠微循环能准确反映血流变化。