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[胆囊切除术后胃十二指肠空肠电活动的恢复。在哺乳动物中的原位研究]

[Recovery of gastroduodenojejunal electric activity after cholecystectomy. In situ study in mam].

作者信息

Lemaire M, Riezzo G, Pezzolla F, Thouvenot J, Giorgio I

机构信息

Laboratoire de Physiologie, CHU Tours, France.

出版信息

Arch Int Physiol Biochim Biophys. 1993 Jan-Feb;101(1):93-9. doi: 10.3109/13813459308998136.

Abstract

The recovery of gastrointestinal electrical activity--migrating myoelectrical complex (MMC) and slow waves--was studied in six women (50-77 years) after cholecystectomy for gallstones: serosal electrodes in pairs are implanted in the wall of the antrum, duodenum and jejunum during surgery. Five hour recordings were made on the first, third and fourth postoperative days (pOD), in starvation condition with hydric intake only. The recordings were made after a twelve hour fast. On the fourth postoperative day, a test meal (250 g yogurt) was given to the patients and its effects on electrical activity were recorded for 2 hours. Even though MMC were present on the first and third postoperative days, a detailed study of their origin, the length of the phase 3 and the speed of gastro-jejunal propagation showed an inhibition of gastric MMC until the fourth pOD, moreover that intestinal MMC was slower than normal until the third pOD. On the fourth postoperative day, gastric inhibition disappeared since the length of the phase 3 of the MMC in the gastric level corresponded to those of the duodenum and jejunum. Furthermore the speed of propagation corresponded to that in normal subjects. Further, the slow wave frequency peculiar to each segment studied increased progressively from the first to the fourth pOD just like the slow waves with action potentials. In conclusion, notwithstanding the presence of MMC from the first postoperative day, it was only on the fourth day that normal coordination was restored and hence that patients were able to eat again.

摘要

对6名(年龄在50 - 77岁之间)因胆结石接受胆囊切除术的女性患者的胃肠电活动——移行性肌电复合波(MMC)和慢波的恢复情况进行了研究:在手术过程中,将成对的浆膜电极植入胃窦、十二指肠和空肠壁。在术后第一天、第三天和第四天(pOD),在仅摄入水分的饥饿状态下进行5小时的记录。记录在禁食12小时后进行。在术后第四天,给患者提供一顿试验餐(250克酸奶),并记录其对电活动的影响,持续2小时。尽管在术后第一天和第三天存在MMC,但对其起源、第3期时长以及胃肠 - 空肠传播速度的详细研究表明,直到术后第四天胃MMC仍受到抑制,而且直到术后第三天肠MMC都比正常情况慢。在术后第四天,胃抑制消失,因为胃水平MMC第3期的时长与十二指肠和空肠的时长相当。此外,传播速度与正常受试者的速度一致。此外,所研究的每个节段特有的慢波频率从术后第一天到第四天逐渐增加,就像带有动作电位的慢波一样。总之,尽管术后第一天就存在MMC,但直到第四天才恢复正常协调,患者因此能够再次进食。

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