结扎小肠一侧系膜肠壁血管对其血运的影响——肠壁双血运现象实验研究  

VIABILITY OF THE BOWEL AFTER THE LIGATURE OF ONE-SIDE INTESTINAL STRAIGHT ARTERY

作　　者：李龙[1] 张金哲[1] 陈晋杰[1] 张连柱[1] 董瑞安[1] 

机构地区：[1]北京儿童医院小儿外科,100045

出　　处：《现代手术学杂志》1998年第3期190-193,共4页

摘　　要：目的:了解结扎切断小肠一侧系膜肠壁血管对整个肠壁的影响。方法:实验对象为新西兰大白兔25只,随机分为对照组5只,急性实验组10只和慢性组10只。对急性实验组动物,结扎切断15cm范围的末段回肠的一侧系膜肠壁血管,观察肠壁的血运变化;慢性实验组动物,相同方法结扎一侧系膜血管,然后饲养一个月。再行剖腹手术观察肠管情况。实验之肠管均行血管构筑,扫描电镜观察。结果:对照组中可见小肠系膜的Ⅲ级血管弓向两侧肠壁发出系膜肠壁血管,其主干在两侧肠壁的中1/3段内穿入肌层,在粘膜下层呈树枝状分支,与相邻和对侧的系膜肠壁血管分支相吻合形成粘膜下血管网,遍布整个粘膜下层。由此血管网向粘膜层和肌层分别发出分支形成粘膜毛细血管丛和肌层毛细血管丛。断离一侧系膜肠壁血管后30min和一个月后,肠壁的血运无障碍,肠管蠕动良好,无狭窄及造成肠梗阻者。电镜下见肠壁的粘膜下血管网及粘膜和肌层血管丛完整。结论:结扎小肠一侧系膜肠壁血管不影响整个肠壁的血运,结扎侧的肠壁靠其粘膜下的血管网供血,因此可以认为小肠壁受两侧系膜肠壁血管的双重供血,这将为单纯切除重复畸形肠管和淋巴性肠系膜囊肿术式的建立提供理论依据。Intestinal duplication and its adjacent small bowel share a single mesentery with straight arteries from the arcade supplying the normal bowel and the duplication. The usual surgical management is resection of the duplication and the adjacent bowel. The aim of this study was to conduct an experimental study of blood supply to the bowel and consequneces of ligation of the straight arteries to one side of the bowel. Material and methods: the sutdy was carried out on 25 New Zealand white rabbits. The intestinal blood supply of three groups of rabbits(control, acute and chronic) have been studied by perfusion, microdis-section, stereoscopic microscopic examination and scanning electron microscopy after impregnation with gold, after ligation of the straight arteries to one side of the intestine. Conclusion:ligation of one - side of the straight artery does not interfere with the viability of the bowel.

关 键 词：小肠结扎术 肠壁血管 肠系膜 血运现象 黏膜层 

分 类 号：R656.7[医药卫生—外科学]