Medeiros J A, Pontes F A, Mesquita O A
Instituto de Fisiologia, Faculdade de Medicina, Universidade de Coimbra, Portugal.
Dis Colon Rectum. 1997 Jan;40(1):93-9. doi: 10.1007/BF02055689.
This study was designed to investigate colonic spike bursts regarding 1) their migration behavior, 2) their pressure correlates, and 3) comparing colonic short spike bursts with spike bursts from migrating myoelectric complex from the small bowel.
Rectosigmoid electromyography and manometry were recorded simultaneously in seven normal volunteers and electromyography alone in five others during two hours of fasting and for two hours after one 2,100-kJ meal. One patient with an ileostomy was also studied by the same method to record the migrating myoelectric complex from the terminal ileum during fasting.
Three kinds of spike bursts were observed in the pelvic colon: rhythmic short spike bursts, migrating long spike bursts, and nonmigrating long spike bursts. The meal significantly increased the number of migrating and nonmigrating long spike bursts (from 25 to 38.7 percent of the recording time; P < 0.01). These bursts of potentials showed a peak 15 minutes after the meal, which may be caused by the gastrocolic reflex. Migrating long spike bursts started anywhere along the rectosigmoid and migrated from there aborad 82 percent of the time and orad or in both directions in 10 or 7 percent of the time, respectively. They originated pressure waves 99 percent of the time. Short spike bursts were more frequent before the meal (15.1 percent before and 9.6 percent after the meal), but the difference was not significant; they neither propagated nor initiated pressure waves detected by the mini-balloon.
Migrating long spike bursts were the only potentials that migrated, sometimes for short distances. Short spike bursts are a different phenomenon from the small-bowel migrating myoelectric complex because they do not migrate; they can occur during the postprandial period and never originated intraluminal pressure waves.
本研究旨在探讨结肠棘波爆发的以下方面:1)其迁移行为;2)与压力的相关性;3)比较结肠短棘波爆发与小肠移行性肌电复合波的棘波爆发。
对7名正常志愿者同时进行直肠乙状结肠肌电图和测压记录,另外5名志愿者在禁食2小时及进食一顿2100千焦的餐后2小时仅进行肌电图记录。还对1名回肠造口患者采用相同方法进行研究,以记录禁食期间末端回肠的移行性肌电复合波。
在盆腔结肠中观察到三种棘波爆发:节律性短棘波爆发、移行长棘波爆发和非移行长棘波爆发。进食显著增加了移行性和非移行长棘波爆发的数量(从记录时间的25%增至38.7%;P<0.01)。这些电位爆发在进食后15分钟出现峰值,这可能是由胃结肠反射引起的。移行长棘波爆发在直肠乙状结肠的任何部位起始,82%的时间从那里向肛侧迁移,10%或7%的时间分别向口侧或双向迁移。它们99%的时间会引发压力波。短棘波爆发在进食前更频繁(进食前为15.1%,进食后为9.6%),但差异不显著;它们既不传播也不引发微型气球检测到的压力波。
移行长棘波爆发是唯一会迁移的电位,有时迁移距离较短。短棘波爆发与小肠移行性肌电复合波是不同的现象,因为它们不迁移;它们可在餐后出现,且从不引发腔内压力波。