Seimiya S
Second Department of Surgery, Toho University School of Medicine, Tokyo.
J Smooth Muscle Res. 1994 Jun;30(3):125-34. doi: 10.1540/jsmr.30.125.
In order to study the physiological changes in the intestinal movement after total gastrectomy with jejunal interposition, electromyography was taken from different sites of small intestine of the dogs with and without gastrectomy. Both 6 and 12 months after surgery, the frequency of the basic electric rhythm (BER) of interposed jejunum was lower and that of distal jejunum was much lower than that of duodenum. Most of the interdigestive migrating electric complexes (IMEC) was originated in the oral side of the interposed jejunum; the rate of occurrence increased after the operation further and reached to 91.5% one year after the operation. Most of the dogs showed the propagation pattern from interposed jejunum to duodenum and to distal jejunum; this tendency increased after the operation and 80.8% of the dogs showed this pattern one year after the operation. Thus, the IMEC, conducted usual intestinal order disappeared after the operation and those originated from oral to anal side, regardless of their original order. These results suggest that the order of the propagation of IMEC were determined by the order of the portion of intestine after operation and the parietal continuity, rather than extrinsic nerves, is involved in the propagation. It is also suggested that the propagation of IMEC is not always correlated with the gradient in the difference of the BER between the replaced jejunum and duodenum.
为研究全胃切除空肠间置术后肠道运动的生理变化,对行胃切除和未行胃切除的犬小肠不同部位进行肌电图检查。术后6个月和12个月时,间置空肠的基本电节律(BER)频率均低于十二指肠,远段空肠的BER频率则更低。多数消化间期移行性复合运动(IMEC)起源于间置空肠的口侧;术后发生率进一步增加,术后1年达91.5%。多数犬呈现从间置空肠向十二指肠及远段空肠的传播模式;术后这种趋势增强,术后1年80.8%的犬呈现此模式。因此,术后按正常肠道顺序传导的IMEC消失,取而代之的是无论其原顺序如何均从口侧向肛侧起源的IMEC。这些结果提示,IMEC的传播顺序由术后肠段顺序决定,且壁层连续性而非外在神经参与了传播过程。还提示IMEC的传播并不总是与被置换空肠和十二指肠之间BER差异的梯度相关。