肠肌电图判断肠活力的实验研究

The Experiment Study:Assessment of Intestinal Viability by Electromyogram

为探讨术中肠肌电图法（ＥＭＧ）对肠活力的评价作用，将 ３２只家兔随机分为４组，选取１０ｃｍ长末端小肠制成肠袢肠缺血模型，分别造成缺血１、２、３和 ４ｈ、双极银电极记录缺血前（ａ）、缺血末（ｂ）和再灌注３０ ｍｉｎ（ｃ）时的 ＥＭＧ变化。 ４８ｈ后再次开腹，取原缺血肠段作光镜和电镜观察。结果显示：缺血≥３ ｈ的肠段，ＢＥＲ的ｆｃ明显低于 ｆａ（ Ｐ＜０． ０５）；缺血＜３ ｈ的肠段，ｆｃ变化不明显；（ｆａ－ｆｃ）的变化与 ４８ ｈ后肠的病理损伤程度呈正相关（γ＝０．５０７）；ＥＭＧ振幅在再灌注后降低。表明ＥＭＧ能用于术中评价缺血肠活力，对预测术后近期肠管生存质量有一定的临床价值。

To realize the intraoperative intestinal electromyogram (EMG) which may have a reliable role in assessment of intestinal viability. Thirty-two albino rabbits were divided into four groups randomly. An isolated ischemic bowel loop in 10 cm length was made in each rabbits. The clamp and rubber bands were released at intervals of 1,2, 3 and 4 hours in different groups. Bipolar EMGs of the ischemic loop were taken before, just before the end of and 30 minutes after the clamping. The involved intestines were observed under light-and electro-scope 48 hours after the first operation. In all loops encountering over three hours ischemia the postreperfusion BER (Basic electric rythm) frequency(fc) dropped significantly compared with those (fa) before ischemia (P<0. 05). However, in those ischemia less than three hours, the frequency didn't change obviously. there was positive correlation between the decrement of BER frequency and pathological degree (γ= 0. 507). The wave amplitude decreased after reperfusion. The operative EMG plays a role in assessing the viability of ischemic bowel.