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目的 通过监测食管癌切除术后患者消化间期胃窦、幽门、十二指肠移行性复合运动波(MMC)的变化 ,探讨胸部胃对固体食物排空延缓的发生机制。 方法 食管癌切除术后第 7～ 11天 ,通过 8通道袖套式测压导管监测患者胃窦、幽门、十二指肠的运动。 结果 幽门、十二指肠检出 2 8个MMC周期 ;胃窦检出 12个MMC周期 ,其中 4次MMCⅢ相活动后于十二指肠MMCⅢ活动的发生。MMC周期平均持续时间 :胃窦 (49 2± 10 5 )min ,幽门 (46 5± 10 4 )min ,十二指肠 (45 9± 10 0 )min ;MMCⅢ相平均持续时间 :胃窦 (6 7± 3 5 )min ,幽门 (10 0± 3 5 )min ,十二指肠 (8 0± 3 9)min。MMCⅢ相收缩波的平均振幅 :胃窦 (83± 30 )mmHg,幽门 (6 0± 12 )mmHg ,十二指肠 (5 5± 4 )mmHg。结论 胃窦MMCⅢ相活动次数及其收缩波平均振幅的减小 ,胃窦、幽门、十二指肠MMCⅢ时相的不协调运动是胸部胃对固体食物排空延缓的重要原因之一。
Objective To investigate the mechanism of delayed gastric emptying of solid food by monitoring the changes of migrating compound movement wave (MMC) in gastric antrum, pylorus and duodenum during the process of esophageal cancer resection. Methods From the seventh day to the eleventh day after resection of esophageal cancer, the movement of gastric antrum, pylorus and duodenum was monitored by 8-channel cuff-type manometry catheter. Results Pylorus and duodenum detected 28 cycles of MMC. 12 cycles of MMC were detected in gastric antrum. Among them, 4 cycles of MMC Ⅲ activity were observed in duodenal MMC Ⅲ. The mean duration of MMC cycle was (49 2 ± 10 5) min, pylorus (46 5 ± 10 4) min and duodenum (45 9 ± 10 0) 7 ± 35 min, pylorus (10 0 ± 3 5) min and duodenum (80 ± 3 9) min. The average amplitude of MMC Ⅲ phase contractile wave: gastric sinus (83 ± 30) mmHg, pylorus (60 ± 12) mmHg and duodenum (54 ± 4) mmHg. Conclusions The frequency of MMC Ⅲ phase activity in gastric antrum and the decrease of average amplitude of its contractile wave were observed. The uncoordinated phase of MMC Ⅲ in the antrum, pylorus and duodenum was one of the important reasons for delayed gastric emptying of solid food.