<<
>>

Motor function of a gastroenteric tract at healthy surveyed children

The first works on studying of an electrophysiology of a gastroenteric tract concern the beginning of the last century. The configuration and amplitude electrogramme izmenchiva also depends on a functional condition of organs of a gastroenteric tract, a way of registration (intra-and extracellularly, unipolarly or bipoljarno), designs of an electrode, a way of its bracing or implantation, orientation of bipolar electrodes concerning a longitudinal axis of an investigated organ, interelectrode distance and resistance, time of stay of electrodes in an organism. (Materials of XIII Congress of children's gastroenterologists of Russia - 2006г. »» Illnesses of the top departments digestive a tract)

At the heart of an electrophysiology the doctrine about sintsitivnosti gladkomyshechnoj tissues owing to which certain zones GASTROINTESTINAL TRACT operate as electric drivers of a rhythm - pejsmejkery GASTROINTESTINAL TRACT lays, from them the wave depoljarizatsii extends on other departments of an intestinal tube. This property gladkomyshechnoj a tissue underlies motor and evakuatornoj functions GASTROINTESTINAL TRACT. Thus, registration of electric potentials GASTROINTESTINAL TRACT allows to estimate it motorno-evakuatornuju function (MEF). According to the accepted classification of biological potentials of unstriated muscles allocate:

• Slow electric waves (a basal electric rhythm)

• Spike potentials (spajkovaja activity, action potentials).

Slow electric waves represent periodic phases depoljarizatsii and repoljarizatsii membranes gladkomyshechnyh cells. In experiments in vivo and in vitro it has been noticed, that these changes occur independently, they are not bound to influence of nervous system, humoral regulators, not oppressed under the influence of the pharmacological
Agents. According to a number of authors, slow waves is podporogovye membrane potential changes, and at threshold excess there are spike potentials of action and reduction of muscles.

Besides, it has been noticed, that slow changes of electric activity in GASTROINTESTINAL TRACT occur to enough constant frequency for each of its departments. Frequency of slow electric waves defines the greatest possible frequency of reductions of unstriated muscles GASTROINTESTINAL TRACT. In experiment existence in an intestine prokto - a distal gradient of frequencies also has been taped - frequency of slow waves is maximum in a duodenum and in an initial site of a jejunum and decreases in distal departments of an intestine [43,44].

Spike potentials or action potentials represent rather fast change of a membrane potential which is closely bound to level of a rest potential and amplitude of a slow electric wave, and reflect local reduction of a muscular fiber. Spike potentials arise on a plateau of a slow wave. Force of reduction of a muscular fiber depends on frequency, amplitude and number of spike potentials on electrogramme of an investigated organ. Absence of reductions of muscles out of registration of spike potentials is proved.

The question on localisation pejsmejkera GASTROINTESTINAL TRACT remains opened. The carried out researches have shown, that «the driver of a rhythm» stomach is located in a proximal part of the big curvature, and for a small bowel the given role the proximal department of a duodenum (plays the most probable localisations - area BDS, a verhne-horizontal branch of a duodenum). It generates slow electric waves with frequency of the highest for all small bowel.

However, authentic morphological acknowledgement of localisation pejsmejkernyh zones it is not received. Thus, in experiment it has been proved, that any zone GASTROINTESTINAL TRACT is «the rhythm gauge» for caudally located segments
Or becomes that in certain conditions, for example, at an intestine section that can be the absence indirect demonstration morfologicheski caused pejsmejkernyh zones. Numerous researches had been proved existence of close interrelation between electric and sokratitelnoj activity GASTROINTESTINAL TRACT. Electric and mechanical activity GASTROINTESTINAL TRACT vzaimoobuslovleny also reflect the different parties sokratitelnoj activity: the first - a functional condition of a muscular layer of the organ, the second - presence realised, koordinirovannyh reductions. Thus character and size of bioelectric activity coincides with changes of mechanical activity.

Now electrophysiological methods of research of motor function GASTROINTESTINAL TRACT can be parted on two groups:

• registration of electric potentials with the help vzhivlennyh in a wall of an organ of electrodes, or from mucous by means of probe electrodes - a straight line elektrogastroenterografija

• registration of electric activity from a body surface -

Abdominal wall or extremities -

Peripheric elektrogastroenterografija.

The methods concerning the first group, allow to register changes of action potentials which immediately reflect motor activity of a site of a digestive tube in a zone of a locating of registering electrodes. Advantage of these methods is registration spajkovyh the action potentials arising during the moment depoljarizatsii of muscular cells in a zone of a locating of electrodes. To this process there corresponds occurrence migrating mioelektricheskogo a complex (MMK) which accompanies peristalsis waves in a zone of a finding of measuring electrodes. However necessity to implant electrodes in a wall of an organ and impossibility of an estimation
Bioelectric activity of all departments GASTROINTESTINAL TRACT, limit straight line use elektrogastroenterografii in daily clinical practice [43,44,45].

In 1952 - 1954 M.A.Sobakinym has been offered a technique of registration of electric potentials of a stomach from a body surface.

Updating of the given method was carried out by V.G.Rebrov in 1974 It has suggested to register electric potentials GASTROINTESTINAL TRACT from extremities of the patient. It had been developed classification of the electric signals registered in a strip of frequencies GASTROINTESTINAL TRACT. The method peripheric elektrogastroenterografii (PEGEG) has been as a result framed.

Further works H.P. Parkman and other authors communication between results direct and indirect EGEG [102] has been taped.

The method peripheric EGEG becomes now more and more popular to what the considerable quantity of research works in the given area testifies.

The basic features of the given method are:

• registration of electric activity GASTROINTESTINAL TRACT as as a whole, and in concrete department

• definition of parities of changes of electric activity by a number of laying departments that reflects work of all GASTROINTESTINAL TRACT [45].

Advantages of a method concern it neinvazivnost, absence of contraindications that allows to carry out researches at patients from the first hours of the postoperative period [114].

Application peripheric elektrogastroenterografii in clinic is given reason by a number of the reasons:

The method allows to receive the full objective information about motorno - evakuatornoj functions of various departments GASTROINTESTINAL TRACT.

At early stages allows to tap a functional pathology GASTROINTESTINAL TRACT,
Such as motor variants of a dyspepsia, dyskinesia DPK on hypo-and hypermotor type, to carry out differential diagnostics of various forms of chronic duodenal impassability.

Giving the full information about sokratitelnoj abilities of a stomach and DPK, a method peripheric elektrogastroenterografii will allow to diagnose duodenogastralnyj a reflux even during the period toshchakovogo an inspection stage that allows to spend differences of a physiological and pathological reflux and influences ways of treatment of a peptic ulcer.

On character of disturbance of a motility it is possible to carry out differential diagnostics between an ulcer and infiltrativnym a carcinoma of the stomach.

The great value peripheric elektrogastroenterografii has a method for diagnostics of gastrostenoses. Research allows to tap degree and stenosis localisation. To characteristic signs it is possible to distinguish compensated, subcompensated, dekompensirovannye forms of stenoses, and signs of a formed stenosis. In the latter case data peripheric elektrogastroenterografii advance clinical implications of a stenosis, that by us is confirmed at operative treatment of 245 patients.

The method allows to select corrective therapy, and to study mechanisms of influence of medicinal preparations on motor function GASTROINTESTINAL TRACT.

The analysis of the received data includes comparison of the indicators received at toshchakovom research with norm, and also comparison of indicators of the electric activity received after a standard alimentary stimulator, with data toshchakovogo researches of each patient.

Thus, use peripheric PEGEG with the modern computer program of the analysis of data allows to receive the objective and full information about motor and evakuatornoj functions GASTROINTESTINAL TRACT and is the extremely actual technique in pediatrics [102,116].

1.4.2

<< | >>
Scientific source AKOPJAN AJARPI NORIKOVNA. Diagnostics and treatment of functional disturbances of a motility of organs of digestion at children (electromyographic and metabolic aspects). The dissertation on competition of a scientific degree of the candidate of medical sciences. Moscow - 2014. 2014

Ñêà÷àòü îðèãèíàë èñòî÷íèêà

Other medical related information Motor function of a gastroenteric tract at healthy surveyed children:

  1. the Table of contents
  2. Motor function of a gastroenteric tract at healthy surveyed children
  3. THE LITERATURE LIST
  4. THE LITERATURE LIST
  5. 1 modern representations about a chronic gastritis at juvenilnom a chronic arthritis
  6. THE CONCLUSION
  7. Chapter 7 DISCUSSION of RESULTS of RESEARCH
  8. THE LITERATURE LIST
  9. THE LITERATURE LIST