背景:循环运动模式(CMP)是远端结肠的主要运动模式,对健康和疾病都很重要。他们的起源,与生物电慢波的机制和关系仍未完全了解。在腹部手术期间,CMP的增加发生在远端结肠。本研究旨在评估通过术中检测远端人结肠中传播的慢波和尖峰波的可行性,高分辨率(HR),浆膜电测图。
方法:使用经过验证的柔性PCB阵列(6×16电极;4mm电极间间距;2.4cm2,直径0.3mm)从远端结肠获得长达15分钟的HR电记录。获得并分析了无源单极信号。
结果:招募了11例患者(33-71岁;6例女性)在全身麻醉下接受结直肠手术(4例硬膜外手术)。在去除人工制品以及全面的手动和自动化分析之后,在任何患者中均未发现与2至6cpm之间的常规传播活动一致的事件.持续10-180s的间歇性刺状活动簇,每个簇的频率在24到42cpm之间,记录的平均振幅为0.54±0.37mV。
结论:人类术中结肠浆膜定位是可行的,但与胃和小肠不同,显示没有规律的传播电活动。虽然零星,同步尖峰波事件是可识别的。需要替代技术来表征在术中和术后观察到的过度活跃CMP的潜在机制。
结果:本研究的目的是评估通过术中检测可能与远端人结肠循环运动模式相关的传播电活动的可行性,高分辨率,浆膜电测图。人类结肠的高分辨率电测图显示没有规律的繁殖活动,但确实揭示了零星的尖峰波事件。这些发现表明,需要进一步研究适当的技术,以确定在人类手术中和手术后观察到的过度活跃的循环运动模式的机制。
BACKGROUND: Cyclic motor patterns (CMP) are the predominant motor pattern in the distal colon, and are important in both health and disease. Their origin, mechanism and relation to bioelectrical slow-waves remain incompletely understood. During abdominal surgery, an increase in the CMP occurs in the distal colon. This study aimed to evaluate the feasibility of detecting propagating slow waves and spike waves in the distal human colon through intraoperative, high-resolution (HR), serosal electrical mapping.
METHODS: HR electrical recordings were obtained from the distal colon using validated flexible PCB arrays (6 × 16 electrodes; 4 mm inter-electrode spacing; 2.4 cm2, 0.3 mm diameter) for up to 15 min. Passive unipolar signals were obtained and analysed.
RESULTS: Eleven patients (33-71 years; 6 females) undergoing colorectal surgery under general anaesthesia (4 with epidurals) were recruited. After artefact removal and comprehensive manual and automated analytics, events consistent with regular propagating activity between 2 and 6 cpm were not identified in any patient. Intermittent clusters of spike-like activities lasting 10-180 s with frequencies of each cluster ranging between 24 and 42 cpm, and an average amplitude of 0.54 ± 0.37 mV were recorded.
CONCLUSIONS: Intraoperative colonic serosal mapping in humans is feasible, but unlike in the stomach and small bowel, revealed no regular propagating electrical activity. Although sporadic, synchronous spike-wave events were identifiable. Alternative techniques are required to characterise the mechanisms underlying the hyperactive CMP observed in the intra- and post-operative period.
RESULTS: The aim of this study was to assess the feasibility of detecting propagating electrical activity that may correlate to the cyclic motor pattern in the distal human colon through intraoperative, high-resolution, serosal electrical mapping. High-resolution electrical mapping of the human colon revealed no regular propagating activity, but does reveal sporadic spike-wave events. These findings indicate that further research into appropriate techniques is required to identify the mechanism of hyperactive cyclic motor pattern observed in the intra- and post-operative period in humans.