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犬急性肠梗阻期间运动变化的机制

Mechanisms of motility changes during acute intestinal obstruction in the dog.

作者信息

Prihoda M, Flatt A, Summers R W

出版信息

Am J Physiol. 1984 Jul;247(1 Pt 1):G37-42. doi: 10.1152/ajpgi.1984.247.1.G37.

DOI:10.1152/ajpgi.1984.247.1.G37
PMID:6742196
Abstract

We investigated the effects of autonomic drugs and the role of intestinal contents on the motility changes that occur during acute obstruction. Myoelectric activity was recorded from seven electrodes spaced at 3-cm intervals along the midjejunum of nine conscious dogs. Another animal had electrodes evenly placed throughout the small bowel. Obstruction was created by inflation of an intraluminal balloon. Systemic arterial blood pressure and pulse rate were monitored. Initially, motor activity of the small intestine increased proximal to an acute intestinal obstruction and decreased distally. Recordings from the entire small intestine revealed that these effects occurred almost immediately in the region of the obstruction but not at more distant sites. Within 2-3 h, however, proximal hypermotility had extended to the duodenum and distal inhibition had progressed to the terminal ileum. Diversion of intestinal contents without obstruction reduced myoelectric activity distal to the site of drainage. However, reinfusion of chyme distal to the site of obstruction failed to restore inhibited motor activity to control levels. Atropine sulfate (50 micrograms/kg) decreased and neostigmine (5 micrograms X kg-1 X min-1) potentiated the hyperactivity proximal to the obstruction, but neither agent significantly affected the distal inhibition. Phentolamine (1 mg/kg) and propranolol (1 mg/kg) had no effect on proximal or distal motor activity during obstruction; these were doses that blocked cardiovascular responses to adrenergic agonists. These results suggest that changes in luminal contents and in nervous activity both contribute to the intestinal motility changes that accompany obstruction.(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

我们研究了自主神经药物的作用以及肠内容物在急性肠梗阻期间发生的运动变化中的作用。从9只清醒犬空肠中段沿肠管间隔3厘米放置的7个电极记录肌电活动。另一只动物的电极均匀分布于整个小肠。通过向肠腔内气囊充气造成梗阻。监测体循环动脉血压和脉搏率。最初,急性肠梗阻近端小肠的运动活性增加,远端则降低。对整个小肠的记录显示,这些效应在梗阻部位几乎立即出现,但在更远端的部位则没有。然而,在2 - 3小时内,近端的运动亢进扩展至十二指肠,远端的抑制则进展至回肠末端。在无梗阻情况下使肠内容物改道可降低引流部位远端的肌电活动。然而,在梗阻部位远端回输食糜未能将受抑制的运动活性恢复至对照水平。硫酸阿托品(50微克/千克)降低了梗阻近端的运动亢进,新斯的明(5微克·千克⁻¹·分钟⁻¹)则增强了该运动亢进,但两种药物均未显著影响远端的抑制。酚妥拉明(1毫克/千克)和普萘洛尔(1毫克/千克)在梗阻期间对近端或远端的运动活性均无影响;这些剂量可阻断对肾上腺素能激动剂的心血管反应。这些结果表明,管腔内内容物的变化和神经活动均有助于肠梗阻时伴随的肠道运动变化。(摘要截选至250词)

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