Quigley E M, Thompson J S
Department of Internal Medicine, Omaha Veterans Administration Hospital, Nebraska.
Gastroenterology. 1993 Sep;105(3):791-8. doi: 10.1016/0016-5085(93)90897-l.
The mucosal response to intestinal resection has been extensively studied; little is known of the motor response. Our aim was to evaluate motility in the intestinal remnant following distal resection.
Motor activity, duodenocecal transit, nutrition, and absorption were studied over a 3-month period in control animals (n = 9) and in groups of dogs who had undergone 25% (n = 6), 50% (n = 5), and 75% (n = 5) distal resection.
Diarrhea and steatorrhea developed in each resection group, and the 75% group alone developed true short bowel syndrome. Resection did not affect migrating motor complex frequency or periodicity; phase 1 duration was shorter in the 75% group (control vs. 75%: 22 +/- 4 vs. 6 +/- 2 minutes, P < 0.03). The most striking motor effect was the development of prominent cluster activity in the distal part of the remnant in 25% and 50% resection animals and throughout the remaining intestine in the 75% group. Duodenocecal transit slowed during the study period from 13 +/- 1 to 20 +/- 2 minutes in the 50% and from 10 +/- 2 to 14 +/- 2 minutes in the 75% group (P < 0.05).
The initial motor response to major resections of the distal small intestine is dominated by the development of abnormal patterns. This motor disruption may contribute to the symptomatology and clinical features of the short bowel syndrome.
对肠道切除术后的黏膜反应已进行了广泛研究;而对运动反应的了解却很少。我们的目的是评估远端切除术后肠道残端的运动情况。
在3个月的时间里,对对照组动物(n = 9)以及分别接受了25%(n = 6)、50%(n = 5)和75%(n = 5)远端切除的犬组进行运动活性、十二指肠 - 盲肠转运、营养和吸收方面的研究。
每个切除组均出现腹泻和脂肪泻,仅75%切除组出现了真正的短肠综合征。切除并未影响移行运动复合波的频率或周期性;75%切除组的第1期持续时间较短(对照组与75%切除组:22±4分钟对6±2分钟,P < 0.03)。最显著的运动效应是,在25%和50%切除动物的残端远端出现明显的簇状活动,而在75%切除组中,整个剩余肠道均出现这种情况。在研究期间,十二指肠 - 盲肠转运减慢,50%切除组从13±1分钟增至20±2分钟,75%切除组从10±2分钟增至14±2分钟(P < 0.05)。
远端小肠大部切除术后的初始运动反应主要表现为异常模式的出现。这种运动紊乱可能导致短肠综合征的症状和临床特征。