Roux-Y胆管空肠吻合术后输出肠袢动力障碍的研究

Study on post-cholangiojejunostomy dynamic disorder of Roux limb.Zha

目的检测Ｒｏｕｘ－Ｙ胆管空肠吻合术后Ｒｏｕｘ肠袢的动力改变，探讨胆肠吻合术后消化道功能紊乱发生的可能机制。方法将胃肠功能测压管置入５例行胆肠吻合术病人的Ｒｏｕｘ肠袢至吻合口处；另设５例行胆总管探查术病人作为对照，并将测压管置入相应空肠段。记录分析消化间期移行性运动复合波（ｍｉｇｒａｔｉｎｇｍｏｔｏｒｃｏｍｐｌｅｘ，ＭＭＣ）。结果Ｒｏｕｘ肠袢ＭＭＣ周期明显短于对照组［（７２８±１７４）ｍｉｎ与（９５４±１２５）ｍｉｎ比较，ｔ＝２３６，Ｐ＜００５］，有不能通过吻合口的波和逆向传导波存在。结论Ｒｏｕｘ肠袢动力障碍导致的细菌异常生长和胆汁、肠液反流。

Objective To examine post-cholangiojejunostomy dynamic disorder of Roux limb,and study the mechanism of digestive disorder after cholangiojejunostomy. Methods Five patients undergoing Roux-Y cholangiojejunostomy were implanted 5 force transducer strain gauges around Roux anastomosis,and another 5 patients undergoing choledochstomy were implanted at corresponding site of jejunum.The migrating motor complex(MMC)was recorded and analyzed. Results Period of Roux MMC was significantly shorter than MMC of control group(72\^817\^4min vs 95\^412\^5min,P<0\^05).Some waves which could not propagate anastomosis and some antidromic waves were discovered in Roux group. Conclusion Anomalous growth of microorganisms,and reflux of bile and intestinal juice is the major cause of digestive disorder after cholangiojejunostomy.