Hallgren T, Oresland T, Andersson H, Hultén L
Dept. of Surgery, University of Göteborg, Sahlgrenska sjukhuset, Sweden.
Scand J Gastroenterol. 1994 Nov;29(11):1017-23. doi: 10.3109/00365529409094879.
Ileostomy output and small-intestinal transport are regulated by complex mechanisms, which the present study aimed to further elucidate.
The time-related ileostomy output and bile acid excretion after intraduodenal administration of a fat solution (oleic acid, 3.5 g) was studied in 29 ileostomy patients. Eighteen patients had the entire small bowel preserved (group I), whereas 11 had various lengths of the ileum resected or bypassed (group II).
Intraduodenal fat administration resulted in a prompt and significant increase in ileostomy output in both groups. The accumulated 2-h output after fat administration amounted to 60% of the normal 24-h output in group I and 30% in group II. A marked increase in bile acid excretion preceded the flow response. The fat-induced response was abolished by administration of cholestyramine.
Bile acids seem to have important regulatory effects with regard to secretion/absorption and transport of small-bowel contents, affecting ileostomy output, with clinical implications in many patients.
回肠造口术的排出量和小肠转运受复杂机制调控，本研究旨在进一步阐明这些机制。
对29例回肠造口术患者进行了研究，观察十二指肠内给予脂肪溶液（油酸，3.5克）后回肠造口术排出量及胆汁酸排泄随时间的变化。18例患者保留了完整的小肠（I组），11例患者切除或绕过了不同长度的回肠（II组）。
十二指肠内给予脂肪后，两组的回肠造口术排出量均迅速显著增加。脂肪给药后2小时的累积排出量在I组中占正常24小时排出量的60%，在II组中占30%。胆汁酸排泄的显著增加先于流量反应。给予消胆胺后，脂肪诱导的反应被消除。
胆汁酸似乎对小肠内容物的分泌/吸收和转运具有重要的调节作用，影响回肠造口术的排出量，对许多患者具有临床意义。
