胃十二指肠吻合口异常肌电活动对胃排空的影响

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.

Impact of abnormal myoelectricity at gastroduodenal anastomosis on gastric emptying in rats

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.