Behrns K E, Sarr M G, Hanson R B, Zinsmeister A R
Department of Surgery, Mayo Clinic and Foundation, Rochester, Minnesota, USA.
Dig Dis Sci. 1996 May;41(5):884-93. doi: 10.1007/BF02091527.
This study was designed to determine if extrinsic innervation and intrinsic neural continuity with the duodenum (neuroenteric physiologic pathways disrupted during intestinal transplantation) modulate the characteristics of interdigestive motor activity in the canine small bowel. Five dogs served as neurally intact controls (group 1) and 10 dogs (group 2) underwent a model of jejunal autotransplantation involving in situ neural isolation of the jejunoileum. Fasting duodenal and jejunal motor activity was recorded on-line to a microcomputer using closely spaced duodenal and jejunal manometry catheters. Characteristics of global motor patterns, the migrating motor complex (MMC), and local motor patterns, including individual contractions and grouped clustered contractions, were determined. Neural isolation of the jejunoileum disrupted coordination of duodenal and jejunal phase III activity, increased the variability of cycling of the MMC, decreased the period of the jejunal MMC, and increased motility indices in the neurally isolated jejunum. In contrast, single pressure waves and clustered contractions in the neurally isolated jejunum were not altered significantly in incidence or direction, distance, or velocity of spread. In situ neural isolation of the jejunoileum leads to temporal dissociation of the MMC between the transplanted segment (jejunum) and the duodenum but does not appear to alter markedly the characteristics of local contractile activity as measured by individual or grouped contractions. The occurrence of interdigestive jejunal motor patterns and the local organization of individual and grouped small intestinal contractions are not controlled by extrinsic innervation or intrinsic neural continuity with the duodenum.
本研究旨在确定外在神经支配以及与十二指肠的内在神经连续性(在肠道移植过程中被破坏的神经肠生理通路)是否会调节犬小肠消化间期运动活动的特征。五只犬作为神经完整的对照(第1组),十只犬(第2组)接受了空肠自体移植模型,该模型涉及空肠回肠的原位神经隔离。使用紧密间隔的十二指肠和空肠测压导管,将空腹时十二指肠和空肠的运动活动在线记录到微型计算机上。确定了整体运动模式、移行运动复合波(MMC)以及局部运动模式的特征,包括单个收缩和成群收缩。空肠回肠的神经隔离破坏了十二指肠和空肠III期活动的协调性,增加了MMC循环的变异性,缩短了空肠MMC的周期,并增加了神经隔离空肠的运动指数。相比之下,神经隔离空肠中的单个压力波和成簇收缩在发生率、传播方向、距离或速度方面没有明显改变。空肠回肠的原位神经隔离导致移植段(空肠)和十二指肠之间MMC的时间解离,但似乎并未明显改变通过单个或成群收缩测量的局部收缩活动特征。消化间期空肠运动模式的出现以及单个和成群小肠收缩的局部组织不受外在神经支配或与十二指肠的内在神经连续性的控制。