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首页> 外文期刊>World Journal of Gastroenterology >Distal small bowel motility and lipid absorption in patients following abdominal aortic aneurysm repair surgery.
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Distal small bowel motility and lipid absorption in patients following abdominal aortic aneurysm repair surgery.

机译：腹主动脉瘤修复手术后患者的远端小肠蠕动和脂质吸收。

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AIM: To investigate distal small bowel motility and lipid absorption in patients following elective abdominal aortic aneurysm (AAA) repair surgery. METHODS: Nine patients (aged 35-78 years; body mass index (BMI) range: 23-36 kg/m(2)) post-surgery for AAA repair, and seven healthy control subjects (20-50 years; BMI range: 21-29 kg/m(2)) were studied. Continuous distal small bowel manometry was performed for up to 72 h, during periods of fasting and enteral feeding (Nutrison). Recordings were analyzed for the frequency, origin, length of migration, and direction of small intestinal burst activity. Lipid absorption was assessed on the first day and the third day post surgery in a subset of patients using the (13)C-triolein-breath test, and compared with healthy controls. Subjects received a 20-min intraduodenal infusion of 50 mL liquid feed mixed with 200 microL (13)C-triolein. End-expiratory breath samples were collected for 6 h and analyzed for (13)CO(2) concentration. RESULTS: The frequency of burst activity in the proximal and distal small intestine was higher in patients than in healthy subjects, under both fasting and fed conditions (P<0.005). In patients there was a higher proportion of abnormally propagated bursts (71% abnormal), which began to normalize by d 3 (25% abnormal) post-surgery. Lipid absorption data was available for seven patients on d 1 and four patients on d 3 post surgery. In patients, absorption on d 1 post-surgery was half that of healthy control subjects (AUC (13)CO(2) 1323+/-244 vs 2646+/-365; P<0.05, respectively), and was reduced to the one-fifth that of healthy controls by d 3 (AUC (13)CO(2) 470+/-832 vs 2646+/-365; P<0.05, respectively). CONCLUSION: Both proximal and distal small intestinal motor activity are transiently disrupted in critically ill patients immediately after major surgery, with abnormal motility patterns extending as far as the ileum. These motor disturbances may contribute to impaired absorption of enteral nutrition, especially when intraluminal processing is necessary for efficient digestion.
机译：目的：研究选择性腹主动脉瘤（AAA）修复手术后患者的远端小肠蠕动和脂质吸收。方法：9例AAA修复术后患者（年龄35-78岁；体重指数（BMI）范围：23-36 kg / m（2））和7名健康对照者（20-50岁； BMI范围： 21-29 kg / m（2））进行了研究。在禁食和肠内喂食期间（Nutrison）连续进行远端小肠测压长达72小时。分析记录的频率，起源，迁移长度和小肠爆发活动的方向。在部分患者的术后第一天和第三天，使用（13）C-三油精-呼吸试验评估了脂质吸收，并与健康对照进行了比较。受试者接受20分钟十二指肠内输注的50 mL液体饲料与200 microL（13）C-三油精混合。收集呼气末呼气样品6小时，并分析（13）CO（2）浓度。结果：在禁食和进食条件下，患者近端和远端小肠爆发活动的频率均高于健康受试者（P <0.005）。在患者中，异常传播的突发比例更高（71％异常），这种现象在术后d 3（25％异常）开始恢复正常。术后1天7例患者和3天4例患者可获得脂质吸收数据。在患者中，术后d 1的吸收是健康对照受试者的一半（AUC（13）CO（2）1323 +/- 244对2646 +/- 365；分别为P <0.05），并降低至d 3为健康对照的五分之一（AUC（13）CO（2）470 +/- 832对2646 +/- 365；分别为P <0.05）。结论：危重病人在大手术后立即改变了近端和远端的小肠运动能力，异常的运动模式一直延伸到回肠。这些运动障碍可能会导致肠内营养的吸收受损，尤其是在为了有效消化而需要进行腔内处理时。

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