Distal small bowel motility and lipid absorption in patients following abdominal aortic aneurysm repair surgery

瞄准：在跟随选任的腹的主动脉瘤(AAA ) 修理外科的病人调查远侧的小肠活动性和类脂化合物吸收。方法：九个病人(年老的 35-78 年；身体团索引(BMI ) 范围：23-36 kg/m (2 )) 为 AAA 修理，和七个健康控制题目外科以后(20-50 年；BMI 变化：21-29 kg/m (2 )) 被学习。连续的远侧的小肠测压法为多达 72 h 被执行，在 fasting 并且肠内的的喂(Nutrison ) 的时期期间。记录为频率，起源，一些移植，和小肠的爆炸活动的方向被分析。类脂化合物吸收在病人的一个子集在第一天和第三个天柱子手术被估计用(13 ) C-triolein-breath 测试，并且与健康控制相比。题目收到了 50 mL 液体的 20-min 十二指肠内注入喂与 200 混合了 microL (13 ) C-triolein。结束吐气的呼吸样品为 6 h 被收集并且分析了为(13 ) 公司(2 ) 集中。结果：在近似、远侧的小肠的爆炸活动的频率比在健康题目在病人是更高的，在 fasting 和美联储条件(P【0.005 ) 下面。在病人，有反常地宣传的爆炸的一个更高的比例(71% 反常) ，它开始由 d 使正常化 3 (25% 反常) 外科以后。类脂化合物吸收数据为 d 上的七个病人是可得到的 d 上的 1 和四个病人 3 帖子外科。在病人， d 上的吸收 1 外科以后是健康控制的使遭到的一半(AUC (13 ) 公司(2 ) 1323+/-244 对 2646+/-365；P【0.05，分别地) ，并且被归结为五分之一个由 d 的健康控制的 3 (AUC (13 ) 公司(2 ) 470+/-832 对 2646+/-365；P【0.05，分别地) 。结论：近似、远侧的小肠的马达活动短暂地在主要外科以后立即在非常有病的病人被破坏，与远及回肠延长的反常活动性模式。这些马达骚乱可以贡献肠内的营养的损害吸收，特别当管腔内处理为有效消化是必要的时。

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/m2） 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, odgin, 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 ^13C-triolein-breath test, and compared with healthy controls. Subjects received a 20-min intraduodenal infusion of 50 mL liquid feed mixed with 200μL ^13C-triolein. End-expiratory breath samples were collected for 6 h and analyzed for ^13CO2 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 ^13CO2 1323±244 vs 2646±365; P〈0.05, respectively）, and was reduced to the one-fitch that of healthy controls by d 3 （AUC ^13CO2 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.