中华胃肠外科杂志
中華胃腸外科雜誌
중화위장외과잡지
CHINESE JOURNAL OF GASTROINTESTINAL SURGERY
2010年
11期
842-845
,共4页
尤承忠%董榕%孙井军%杜明华%屈海船%肖家全%汤文浩
尤承忠%董榕%孫井軍%杜明華%屈海船%肖傢全%湯文浩
우승충%동용%손정군%두명화%굴해선%초가전%탕문호
胃十二指肠吻合%幽门切除术%吻合口%胃排空%肌电活动%大鼠
胃十二指腸吻閤%幽門切除術%吻閤口%胃排空%肌電活動%大鼠
위십이지장문합%유문절제술%문합구%위배공%기전활동%대서
Gastroduodenal anastomosis%Pylorectomy%Stoma%Gastric emptying%Myoelectricities%Rat
目的 探讨胃十二指肠吻合口临近区域的肌电活动对胃排空功能的影响.方法 将32只SD大鼠分成两组,实验组(16只)行幽门切除加胃十二指肠吻合术,吻合口两侧植入电极,对照组(16只)行假手术并于幽门两侧植入电极.记录跨吻合口和幽门的肌电活动:用放射性核素法评估近端胃、远端胃排空功能.结果 术后1周,实验组和对照组胃慢波频率分别为(0.8±1.4)次/min和(3.3±1.2)次/min(P＜0.01),十二指肠慢波频率分别为(2.1±0.6)次/min和(11.1±0.7)次/min(P＜0.01);两组均未见跨越吻合口的慢波传导.术后12～16周,两组胃慢波频率分别为(8.7±0.6)次/min和(4.0±0.4)次/min(P＜0.01),十二指肠慢波频率分别为(11.1±0.8)次/min和(10.8±0.7)次/min(P＞0.05);实验组十二指肠的慢波通过吻合口向胃传导,亦可见到胃慢波通过吻合口向十二指肠的传导.术后12～16周,实验组和对照组平均近端胃半排空时间分别为14.7 min和13.6 min(P＞0.05),平均胃内核素残留率分别为25.4%和39.4%(P＞0.05):平均远端胃半排空时间分别为25.3 min和10.5 min(P＜0.01),平均胃内核素残留率分别为46.4%和18.7%(P＜0.01).结论 胃肠吻合口区域肌电活动异常是导致幽门切除术后胃排空延迟的重要原因之一.
目的 探討胃十二指腸吻閤口臨近區域的肌電活動對胃排空功能的影響.方法 將32隻SD大鼠分成兩組,實驗組(16隻)行幽門切除加胃十二指腸吻閤術,吻閤口兩側植入電極,對照組(16隻)行假手術併于幽門兩側植入電極.記錄跨吻閤口和幽門的肌電活動:用放射性覈素法評估近耑胃、遠耑胃排空功能.結果 術後1週,實驗組和對照組胃慢波頻率分彆為(0.8±1.4)次/min和(3.3±1.2)次/min(P＜0.01),十二指腸慢波頻率分彆為(2.1±0.6)次/min和(11.1±0.7)次/min(P＜0.01);兩組均未見跨越吻閤口的慢波傳導.術後12～16週,兩組胃慢波頻率分彆為(8.7±0.6)次/min和(4.0±0.4)次/min(P＜0.01),十二指腸慢波頻率分彆為(11.1±0.8)次/min和(10.8±0.7)次/min(P＞0.05);實驗組十二指腸的慢波通過吻閤口嚮胃傳導,亦可見到胃慢波通過吻閤口嚮十二指腸的傳導.術後12～16週,實驗組和對照組平均近耑胃半排空時間分彆為14.7 min和13.6 min(P＞0.05),平均胃內覈素殘留率分彆為25.4%和39.4%(P＞0.05):平均遠耑胃半排空時間分彆為25.3 min和10.5 min(P＜0.01),平均胃內覈素殘留率分彆為46.4%和18.7%(P＜0.01).結論 胃腸吻閤口區域肌電活動異常是導緻幽門切除術後胃排空延遲的重要原因之一.
목적 탐토위십이지장문합구림근구역적기전활동대위배공공능적영향.방법 장32지SD대서분성량조,실험조(16지)행유문절제가위십이지장문합술,문합구량측식입전겁,대조조(16지)행가수술병우유문량측식입전겁.기록과문합구화유문적기전활동:용방사성핵소법평고근단위、원단위배공공능.결과 술후1주,실험조화대조조위만파빈솔분별위(0.8±1.4)차/min화(3.3±1.2)차/min(P＜0.01),십이지장만파빈솔분별위(2.1±0.6)차/min화(11.1±0.7)차/min(P＜0.01);량조균미견과월문합구적만파전도.술후12～16주,량조위만파빈솔분별위(8.7±0.6)차/min화(4.0±0.4)차/min(P＜0.01),십이지장만파빈솔분별위(11.1±0.8)차/min화(10.8±0.7)차/min(P＞0.05);실험조십이지장적만파통과문합구향위전도,역가견도위만파통과문합구향십이지장적전도.술후12～16주,실험조화대조조평균근단위반배공시간분별위14.7 min화13.6 min(P＞0.05),평균위내핵소잔류솔분별위25.4%화39.4%(P＞0.05):평균원단위반배공시간분별위25.3 min화10.5 min(P＜0.01),평균위내핵소잔류솔분별위46.4%화18.7%(P＜0.01).결론 위장문합구구역기전활동이상시도치유문절제술후위배공연지적중요원인지일.
Objective To explore the impact of abnormal myoelectricity at gastroduodenal anastomosis on gastric emptying in rats.Methods Rats were randomly divided into experimental group (n =16) and control group (n =16).Pylorectomy and end-to-end gastroduodenal anastomosis were performed in the experimental group and electrodes were implanted in the serosal surface adjacent to the anastomosis.Slow waves were recorded by the implanted electrode in vivo.Gastric emptying was examined by scintigraphy.Results At the first week after surgery,antral slow-wave frequency was significantly lower in the experimental group (0.8± 1.4 vs.3.3 ± 1.2,P＜0.01 ),as was the duodenal slow-wave frequency (2.1±0.6 vs.11.1±0.7,P＜0.01).There was no consecutive slow-waves transduction across the pylorus or the anastomosis.Within 12-16 weeks after operation,antral slow-wave frequency in the experimental group and the control group were (8.7±0.6) cpm and (4.0±0.4) cpm,respectively(P＜0.01 ),and duodenal slow-wave frequency were ( 11.1 ±0.8) cpm and (10.8±0.7) cpm,respectively (P＞0.05).Retrograde and antegrade myoelectricity transduction through the anastomosis were detected.The mean semi-emptying time in the proximal stomach was 14.7 min in the experimental group and 13.6 min in the control group (P＞0.05).Radionuclide retention rate was 25.4% in the experimental group and 39.4% in the control group (P＞0.05).The mean semi-emptying time in the distal stomach was 25.3 min in the experimental group and 10.5 min in the control group (P＜0.01).Radionuclide retention rate was 46.4% in the experimental group and 18.7% in the control group(P＜0.01 ).Conclusion The abnormal myoelectricities in the region of gastroduodenal stoma may delay liquid gastric emptying in pylorectomy rats.
