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胰十二指肠切除术后重建的临床与实验研究——第二部分:胰十二指肠切除术后小肠的肌电活动

[Clinical and experimental study on reconstruction after pancreatectomy--Part II. Myoelectric activity of small intestine after pancreatoduodenectomy].

作者信息

Shiota M

机构信息

First Department of Surgery, Faculty of Medicine, Kyoto University, Japan.

出版信息

Nihon Geka Gakkai Zasshi. 1988 Aug;89(8):1241-51.

PMID:3185491
Abstract

The aim of the study was to investigate the intestinal motility on I-type of reconstruction (e.g. Imanaga procedure) and II-type of reconstruction (e.g. Whipple procedure) following pancreatoduodenectomy in conscious dogs by chronically implanted electrodes along the reestablishing small intestine. During fasting, the interdigestive myoelectric complexes (IMCs) were initiated at a variety of electrode sites in either type of reconstruction. Seventy-six percent of the IMCs which were recorded in I-type dogs were propagated in sequence aborad. On the other hand, in II-type dogs, only 49% of the IMCs was propagated aborad. Furthermore the IMC cycles were more irregular in II-type dogs than in I-type dogs. After a meal, a characteristic fed pattern was induced in I-type dogs, whereas in II-type dogs the response of the small intestine to a meal was suppressed. This study shows that the intestinal myoelectric activity after pancreatoduodenectomy is more markedly disturbed in II-type of reconstruction than in I-type of reconstruction. Such disturbance of the intestinal activity may be a cause of postoperative malnutrition.

摘要

本研究的目的是通过沿重建后的小肠长期植入电极,调查清醒犬胰十二指肠切除术后I型重建(如今泉手术)和II型重建(如惠普尔手术)后的肠道蠕动情况。在禁食期间,两种重建类型的犬在不同电极部位均可启动消化间期肌电复合波(IMC)。在I型犬中记录到的IMC,有76%按顺序向远端传播。另一方面,在II型犬中,只有49%的IMC向远端传播。此外,II型犬的IMC周期比I型犬更不规则。进食后,I型犬诱导出典型的进食模式,而II型犬小肠对进食的反应受到抑制。本研究表明,胰十二指肠切除术后,II型重建的肠道肌电活动比I型重建受到更明显的干扰。这种肠道活动的干扰可能是术后营养不良的一个原因。

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