Cullen J J, Ephgrave K S, Caropreso D K
Department of Surgery, University of Iowa College of Medicine, Iowa City, USA.
Am J Surg. 1996 Jun;171(6):596-9. doi: 10.1016/s0002-9610(96)00037-2.
Gastrointestinal myoelectric activity during postoperative ileus has been well characterized. However, the common clinical scenario of ileus occurring during and after episodes of sepsis is not well understood. The aim of our study was to determine the effects of a single, sublethal dose of endotoxin on canine gastrointestinal myoelectric activity.
Eight dogs underwent placement of serosal electrodes on the stomach and small intestine and insertion of a jejunal cannula. After the animals recovered, electrical activity and jejunal mucosal blood flow were determined during fasting and with feeding. Following completion of these baseline studies dogs were given a single, sublethal dose of Escherichia coli lipopolysaccharide (200 g/kg) intravenously, and the studies were repeated daily for 3 consecutive days.
Endotoxin resulted in an absence of the interdigestive migrating myoelectric complex for 2 days, a decrease in duodenal and jejunal action potentials during fasting and with feeding, but no decreases in jejunal mucosal blood flow. The gastrointestinal myoelectrical patterns returned to those found in health on postendotoxin day 3.
A single, sublethal dose of endotoxin results in a temporary disruption of gastrointestinal myoelectric activity similar to that seen during postoperative ileus. The etiology of this "adynamic" ileus is unknown but does not appear to be secondary to intestinal ischemia.
术后肠梗阻期间的胃肠肌电活动已得到充分描述。然而，脓毒症发作期间及之后发生肠梗阻这种常见临床情况尚不清楚。我们研究的目的是确定单次亚致死剂量内毒素对犬胃肠肌电活动的影响。
八只犬在胃和小肠放置浆膜电极并插入空肠插管。动物恢复后，在禁食和进食期间测定电活动和空肠黏膜血流。完成这些基线研究后，给犬静脉注射单次亚致死剂量的大肠杆菌脂多糖（200 μg/kg），并连续3天每天重复进行研究。
内毒素导致消化间期移行性肌电复合波消失2天，禁食和进食期间十二指肠和空肠动作电位降低，但空肠黏膜血流无减少。内毒素注射后第3天，胃肠肌电模式恢复到健康状态。
单次亚致死剂量内毒素导致胃肠肌电活动暂时中断，类似于术后肠梗阻期间所见。这种“动力缺乏型”肠梗阻的病因尚不清楚，但似乎并非继发于肠道缺血。
