Carbon dioxide insufflation attenuates parietal blood flow obstruction in distended colon - Potential advantages of carbon dioxide insufflated colonoscopy
Carbon dioxide insufflation attenuates parietal blood flow obstruction in distended colon - Potential advantages of carbon dioxide insufflated colonoscopy
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DOI：
10.1007/s00464-005-0252-0
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发表时间：
2006-04-01
影响因子：
3.1
通讯作者：
Nishida, T
中科院分区：
文献类型：
--
作者：
Yasumasa, K;Nakajima, K;Nishida, T
背景：结肠镜检查后肠扩张被认为是血流障碍的原因。二氧化碳（CO2）具有较高的吸收性和血管舒张作用，当用于腔内吹气代替空气时，可以减少扩张结肠的壁血流紊乱。本研究的目的是评估因腔内空气/二氧化碳吹入而扩张的结肠壁血流量。方法：将一段 5 厘米的大鼠结肠吹入空气（空气组）或 CO（CO 组）。采用两种吹气方法：临时吹气至管腔内压力为60mmHg，以及以5、15和30mmHg的压力连续吹气。对通过激光多普勒成像测量的肠扩张和壁血流量进行了评估。结果：对于暂时充气，空气组的肠扩张时间延长，而 CO 组的肠扩张迅速消退。两组的顶壁血流量均减少；然而，在 CO2 组中，它在 5 分钟内恢复。对于连续充气，在5毫米汞柱充气下，空气组的血流量减少，而CO2组的血流量增加。在 15 mmHg 吹气量下，两组的血流量均减少；然而，CO2 组的下降幅度较小。吹气压力与血流差之间存在反向关系。一氧化氮合酶、ATP 敏感 K+ 通道或血红素加氧酶的抑制对于 CO2 诱导的血流量增加无效。结论：CO吹气不仅可以快速缓解肠扩张，而且还可以通过其潜在的血管舒张作用来保留壁血流。
Background: Bowel distention after colonoscopy has been considered as a cause of blood flow disturbance. Carbon dioxide (CO2) with its higher absorbability and vasodilating effect, may reduce parietal blood flow disturbance of distended colon when used for intraluminal insufflation instead of air. The purpose of this study was to assess parietal blood flow of the colon distended with intraluminal air/CO2 insufflation. Methods: A 5-cm segment of rat colon was insufflated with either air (air group) or CO, (CO, group). Two insufflation methods were employed: temporary insufflation Lip to an intraluminal pressure of 60 mmHg and continuous insufflation at a pressure of 5, 15, and 30 mmHg. Bowel distention and parietal blood flow measured by laser Doppler imaging were evaluated. Results: For temporary insufflation, bowel distention was prolonged in the air group, whereas it rapidly resolved in the CO, group. Parietal blood flow decreased in both groups; however, it recovered within 5 min in the CO2, group. For continuous insufflation, under 5 mmHg insufflation, blood flow decreased in the air group, whereas it increased in the CO2 group. Blood flow decreased in both groups under 15 mmHg insufflation; however, it decreased less in the CO, group. There was a reverse relationship between insufflation pressure and blood flow difference. Inhibition of nitric oxide synthase, ATP-sensitive K+ channel, or heme oxygenase was ineffective against a CO2-induced increase in blood flow. Conclusion: CO, insufflation preserved parietal blood flow not only by rapid resolution of bowel distention but also by its potential vasodilative effect.