胃排空(GE)需要精确的横向肠十二指肠协调以实现有效的横向肠血流,其机制尚不清楚。我们旨在将通过十二指肠压力测定(ADM)与GE闪烁显像(GES)评估的胃窦功能相关联,以用于怀疑胃肠道动力障碍的儿童的液体喂养。
对在五年内同时接受ADM和GES的儿童进行了回顾。重新分析ADM示踪以评估窦频率,振幅,餐前和餐后运动指数(MI)。透明传播(TPP)定义为在迁移运动复合体(MMC)的十二指肠III期之前的顺行传播的窦活动。如果TPP发生在所有出现的十二指肠III期的<50%,则将其定义为“不良”。对于GES,整个胃的感兴趣区域,眼底,并绘制胃窦以计算1和2h每个区域的GE半衰期(GE-T1/2)和保留率(RR)。
纳入47名儿童(平均年龄:7.0岁)。22人拥有PIPO,14功能性胃肠道疾病,和11胃轻瘫。TPP较差的儿童的GE-T1/2更长(113.0vs66.5分钟,p=0.028),1小时全胃和眼底的RR较高(79.5%vs63.5%,p=0.038;60.0%对41.0%,分别为p=0.022)和2小时(51.0%对10.5%,p=0.005;36.0%对6.5%,分别为p=0.004)。餐前胃窦收缩幅度与GE-T1/2呈负相关,整个胃的RR,和眼底在2小时。
MMCIII期的TPP与液体的胃排空有关,其对ADM的评估可能预测餐后胃功能的异常。
Gastric emptying (GE) requires precise antropyloroduodenal coordination for effective transpyloric flow, the mechanisms of which are still unclear. We aimed to correlate gastric antral function assessed by antroduodenal manometry (ADM) with GE scintigraphy (GES) for liquid feeds in children with suspected gastrointestinal dysmotility.
Children who underwent both ADM and GES over a five-year period were reviewed. ADM tracings were re-analyzed to assess antral frequency, amplitude, and motility index (MI) pre-prandially and postprandially. Transpyloric propagation (TPP) was defined as antegrade propagated antral activity preceding duodenal phase III of the migrating motor complex (MMC). TPP was defined as \"poor\" if occurring in <50% of all presented duodenal phases III. For GES, regions of interest over the whole stomach, fundus, and antrum were drawn to calculate GE half-time (GE-T1/2 ) and retention rate (RR) in each region at 1 and 2 h.
Forty-seven children (median age: 7.0 years) were included. Twenty-two had PIPO, 14 functional GI disorders, and 11 gastroparesis. Children with poor TPP had longer GE-T1/2 (113.0 vs 66.5 min, p = 0.028), higher RR of the whole stomach and fundus at 1 h (79.5% vs 63.5%, p = 0.038; 60.0% vs 41.0%, p = 0.022, respectively) and 2 h (51.0% vs 10.5%, p = 0.005; 36.0% vs 6.5%, p = 0.004, respectively). The pre-prandial antral amplitude of contractions inversely correlated with GE-T1/2 , RR of the whole stomach, and fundus at 2 h.
TPP during phase III of the MMC correlated with gastric emptying of liquid and its assessment on ADM might predict abnormalities in postprandial gastric function.