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Effects of Intraluminal Pressure and Decompression on Intestinal Obstruction

腔内压力和减压对肠梗阻的影响

基本信息

批准号：
02670589
负责人：
SHIKATA Jun-ichi
金额：
$ 1.54万
依托单位：
Teikyo University School of Medicine
依托单位国家：
日本
项目类别：
Grant-in-Aid for General Scientific Research (C)
财政年份：
1990
资助国家：
日本
起止时间：
1990 至 1991
项目状态：
已结题

来源：
https://kaken.nii.ac.jp/grant/KAKENHI-PROJECT-02670589/
关键词：
Intestinal obstruction Intraluminal pressure Endotoxin Intestinal blood flow Hemodynamics 実験的腸管閉塞

项目摘要

In small bowel obstruction, intraluminal pressure in the distended bowel is one of the most important and basic factors in its pathophysiology. To elucidate a part of the pathophysiology of the bowel obstruction, intraluminal pressure, regional blood flow, and serum endotoxin in small bowel obstruction were investigated. Hemodynamics of hepatic blood flow in endotoxin shock was also studied.Nonstrangulative obstruction was induced experimentally in the canine small intestine of dogs. The intraluminal pressure of the distended intestine was measured every 24 hours for three days, while the dogs were kept in a prone position without being anesthetized. In the measurement of the intraluminal pressure, the hydraulic capillary infusion system (Arndorfer : AMS-600) connected with personal computer was used. It is considered that the intraluminal pressure values of the intestine, as measured by this system, are more physiologic. The significant elevation of the intraluminal pressure was showed on 2 days after simple bowel obstruction. The mean intraluminal pressure on 3 days after. obstruction was 17.9 mmhg in jejunum, and 20.2 mmhg in ileum. The intraluminal pressure values in our experiments are higher than those reported in the past. In motility responses elicited by prostaglandin, the mean pressure amounting 30 mmHg were recorded. Some alterations in regional blood flow and elevation of serum endotoxin levels were also showed in the experimental simple small bowel obstruction.The simple concept of increasing intraluminal pressure provoking directly vascular stasis, edema, and eventually, ischemic damage was abandoned by our studies. It, is suggested that many factors such as elevation of intraluminal pressure, secretory activity of intestine, absorptional disorder of intestine, a tremendous broliferation of the bacterial flora, and chemical mediator sustances are related to the pathophysiology of the intestinal obstruction.

在小肠梗阻中，扩张肠内的腔内压力是其病理生理学中最重要和基本的因素之一。为了阐明肠梗阻的部分病理生理学，对小肠梗阻的肠腔内压力、局部血流和血清内毒素进行了研究。还研究了内毒素休克时肝脏血流的血流动力学。在犬的犬小肠中实验性诱导非绞窄性梗阻。三天内每24小时测量一次扩张肠的腔内压力，同时将狗保持俯卧位而不麻醉。在管腔内压力的测量中，使用与个人计算机连接的液压毛细管输注系统(Arndorfer：AMS-600)。据认为，通过该系统测量的肠腔内压力值更符合生理学。单纯性肠梗阻后2天肠腔内压力显着升高。 3天后的平均腔内压。空肠梗阻为 17.9 mmHg，回肠梗阻为 20.2 mmHg。我们实验中的腔内压力值高于过去报道的值。在前列腺素引起的运动反应中，记录的平均压力为 30 mmHg。在实验性单纯性小肠梗阻中也显示出局部血流的一些改变和血清内毒素水平的升高。我们的研究放弃了管腔内压力增加直接引起血管瘀滞、水肿并最终引起缺血性损伤的简单概念。提示肠腔内压力升高、肠道分泌活动、肠道吸收障碍、菌群大量繁殖、化学介质物质等多种因素与肠梗阻的病理生理有关。