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目的研究介入动脉栓塞后对小肠肌电活动的影响,为小肠病变栓塞治疗后监测肠管存活和指导临床处理提供理论依据。方法20只正常家兔,分别经小肠动脉注射PVA(350~550μm)2、6mg和生理盐水2ml,分为2mg组(10只),6mg组(5只)和对照组(5只)。利用微导管动脉栓塞技术,以基本电节律为观察指标,研究各组动脉栓塞后24h小肠肌电活动的改变。结果2mg组小肠动脉PVA栓塞前后慢波频率和波幅分别为(17.83±0.55)次/min、(0.1641±0.0043)mV和(11.59±0.23)次/min、(0.0739±0.0011)mV,慢波频率和波幅明显下降(P<0.01)。6mg组栓塞后3~6h后基本电节律(basalelectricalrhythm,BER)活动逐渐消失,剖腹探查示肠管发生长短不等坏死。对照组小肠动脉生理盐水注射前后慢波频率和波幅分别为(17.89±0.48)次/min、(0.1632±0.0020)mV和(16.95±0.34)次/min、(0.1606±0.0030)mV,慢波频率和波幅无明显变化(P>0.05)。结论小肠动脉介入栓塞后对小肠BER影响显著,近端空肠电活动的慢波频率和波幅明显下降,小肠动脉介入栓塞后对胃肠道平滑肌慢波电活动主要表现为抑制作用,小肠动脉PVA栓塞后有望通过动态监测BER改变来判断肠壁存活与否。
Objective To study the effect of interventional arterial embolization on the myoelectrical activity of the small intestine to provide a theoretical basis for monitoring the survival of intestine and guiding clinical treatment after the treatment of small bowel embolism. Methods Twenty normal rabbits were divided into 2mg group (10), 6mg group (5) and control group (5) by injecting 2mg of PVA (350 ~ 550μm) and 2ml of saline through the small intestine artery respectively. Using microcatheter arterial embolization, the basic electrical rhythm was taken as the observation index to study the changes of the myoelectrical activity of small intestine 24h after arterial embolism. Results The frequency and amplitude of slow wave before and after PVA embolization in 2 mg group were (17.83 ± 0.55) / min, (0.1641 ± 0.0043) mV and (11.59 ± 0.23) mV, (0.0393 ± 0.0011) mV, And amplitude decreased significantly (P <0.01). The basic electrical rhythm (basalelectricalrhythmicity, BER) activity gradually disappeared 3 to 6 hours after embolization in 6mg group, and laparotomy showed that the length of intestine occurred ranging from necrosis to necrosis. The frequency and amplitude of slow wave in control group were (17.89 ± 0.48) times / min, (0.162 ± 0.002) mV and (16.95 ± 0.34) times / min, (0.1600 ± 0.003) mV, And no significant changes in amplitude (P> 0.05). Conclusions The small intestine BER is significantly affected by small intestinal artery embolization. The frequency and amplitude of slow wave of electrical activity of proximal jejunum are significantly decreased. The slow wave electrical activity of gastrointestinal smooth muscle after embolization of small intestine artery is mainly inhibited. The small intestine artery PVA embolization After the change is expected to be dynamic monitoring BER to determine the survival of the intestinal wall or not.