胆囊切除术对胃肠动力的影响  

Effects of Cholecystectomy on Gastrointestinal Motility

作　　者：孙益红[1] 秦新裕[1] 王承棓[1] 

机构地区：[1]上海医科大学中山医院外科,200032

出　　处：《外科》1997年第4期200-202,共3页

摘　　要：了解人胆囊切除术后早期胃肠运动的变化及自然恢复过程。方法:选择单纯胆囊结石病人20例,分为两组,分别在全麻或硬膜外麻醉下行胆囊切除。手术结束后采用胃肠测压法记录胃肠运动变化,持续至胃肠动力恢复正常。结果:两组病人术后早期、十二指肠移行性动力复合波(migrating motor complex,MMC)活动均消失,术后0.5～2h十二指肠MMC重新出现,胃MMC在术后5.5～14h恢复,术后22～43hMMC完全恢复正常。进食能使术后早期MMC转变为消化期活动形式。比较两组病人术后胃肠动力恢复的各项指标发现,在全麻或硬膜外麻醉下进行手术后胃肠动力的恢复过程无明显差异。结论:胆囊切除术完全消除了正常的胃肠运动,术后胃肠动力的恢复远较传统认为的快。在全麻或硬膜外麻醉下进行手术后胃肠动力的恢复过程无明显差异。Aims:To determine the motility status of gastrointestinal tract during the early postoperative period and its recovery course after cholecystectomy. Methods: Postoperative gas-trointestinal motility were recorded continuously by means of gastrointestinal manometry in 20 patients subject to cholecystectomy. The patients were divided into general anaesthesia group (n= 10) and epidural anaesthesia group (n=10). Results: Normal MMC was abolished during the early postoperative period in all patients. The time of reappearance of the first activity front of the MMC in the duodenum varied from 0.5 to 2 hours. Gastric MMC returned 5.5 to 14 hours postoperatively and normal MMC occurred 22~43 hours after operations. Ingestion of food changed the MMC into a fed pattern during the early postoperative period. There was no difference between the general anaesthesia group and epidural anaesthesia group in terms of gastrointestinal motility. Conclusions: Postoperative gastrointesinal motility recovers faster than that was thought conventionally. Cholecystectomy under general anaesthesia or under epidural anaesthsia makes no difference in terms of postoperative gastrointestinal motility.

关 键 词：胃肠动力 胆囊切除术 麻醉 肠麻痹 

分 类 号：R657.405[医药卫生—外科学] R614[医药卫生—临床医学]