| Objective:This study was designed to establish an objective, quantitative, and accurate monitoring method of bowel sounds in order to detect out gastrointestinal dysfunction in time from patients with severe trauma.Methods:1. Digitized bowel sound collection hardware system was built up by utilizing the personal computer. Collection and analysis software was developed based on LabVIEW8.2 and MATLAB. The characteristic parameters of bowel sounds were analyzed and calculated automatically.2. The characteristic parameters of bowel sounds from 70 healthy volunteers were analyzed first. Then, electrogastroenterogram(EGEG) and blood gastrin (GAS), motilin (MTL)were checked at the same time. The correlation between bowel sounds and EGEG was analyzed.3.39 patients after severe trauma were enrolled in the study. Mean APACHEⅡscored 15.81 (10-30), and the average age was 55.21 yrs. Bowel sounds and EGEG were tested 3 times per day. Blood GAS, MTL, and diamine oxidase (DAO) were checked every 2 days. The ratio of the percentage excretion of ingested doses of lactulose and mannitol in urine (LMR) was tested on the third day.Results:1. Recorded waveforms of bowel sounds were clear and synchronized with the auscultation sound. No bowel sounds omitted in records. For healthy individuals, there were about 43.00±21.70cpm bowel waves with average time 57.43±10.88ms and average frequency 70.48±22.53Hz for each wave, clusters of bowel sounds were about 8.5cpm.2. For healthy adults, mean time of bowel sound waves had positive correlation with the low frequency of intestinal electroactivities(r=0.355) and negative correlation with the fast bowel frequency(r=-0.357), P<0.05. There was no correlation between bowel sounds and EGG parameters. Neither was to motilin, and gastrin, P> 0.05.3. In severe trauma patients, the amount of bowel sounds significantly lower than those in the healthy during the first 4 days, P<0.01. The percentage of normal frequency in EGG decreased significantly on the 2nd to 3rd day, and lowered obviously in intestinal electric activity in 5 days. Gastrin increased gradually from day 1 after injury to day 5, and reached to 137.40±121.41 pg/ml, that was 3 times to the healthy level, P<0.01. Motilin were significantly higher on the day 1,3,5 after injury. DAO increased on day 1 and day 5. LMR was 0.1076±0.2808 on the 3rd day. There were 35.7% individuals whose LMR>0.0373.Conclusions:1. Digitized bowel sound analysis makes it feasible to check conveniently, record accurately and analyze subjectively and quantitatively. It enhance sensitivity of detecting bowel sounds. It can do re-read also. Therefore, It makes dynamic monitoring possible, which is important for intensive care.2. There is positive correlation between bowel sound time and intestinal electrical frequency. If the average time of bowel sounds prolong, abnormal intestinal electric activity maybe exist. Therefore, digitized bowel sound analysis can be used as the monitoring of intestinal motor function more simple and reliable than auscultation.3. Severe trauma patients undergo gastrointestinal motility decline, hormones undulate, and mucosal barrier dysfunction, which exacerbate in the period of day 2 to 4 after injury, thus, it is the key time to prevent and treat of gastrointestinal motility disorders. Closely monitor should be implemented.4. Monitoring and analysis of bowel sounds possess specific functions for severe trauma patients as it can indicate the severity of disease and gastrointestinal motility disorder.
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