青霉胺预防腹腔粘连及其对肠管吻合口和腹壁切口愈合的影响  

EFFECTS OF PENICILLAMINE ON PREVENTION OF INTRA-ABDOMINAL ADHESION AND HEALING OF ANASTOMOSIS OF SMALL INTESTINE AND ABDOMINAL-WALL INCISIONS——AN EXPERIMENTAL STUDY

作　　者：孙福涛[1] 王军[1] 张鲁杰[2] 

机构地区：[1]临沂市人民医院小儿外科,山东临沂276003 [2]临沂市人民医院营养科,山东临沂276003

出　　处：《齐鲁医学杂志》2006年第6期481-484,共4页Medical Journal of Qilu

摘　　要：目的研究青霉胺预防腹腔粘连的作用及其对肠管吻合口和腹壁切口愈合的影响,同时观察青霉胺的副作用。方法将60只Wistar大白鼠随机平均分为5组,开腹行小肠纵切横缝手术,分别给予生理盐水和不同剂量的青霉胺处理,观察各组大鼠腹壁切口愈合情况及腹腔内肠管粘连情况,进行肠管吻合口和腹壁切口的抗张力测试,并行肠管吻合口和腹壁切口标本的普通病理及免疫组化染色检查。结果腹腔粘连积分用药各组均明显低于对照组;腹壁切口抗张力用药各组都有明显的下降,但大体外观均为甲级愈合;肠管吻合口皆无溢漏,其抗张力均高于正常肠壁;病理及免疫组化染色检查用药各组肠管吻合口和腹壁切口标本中毛细血管、成纤维细胞和胶原纤维数量与对照组相比都有较明显的减少。结论青霉胺具有良好的预防术后腹腔粘连作用,同时能够降低腹壁切口抗张力,对肠管吻合口无影响;在浓度过高或剂量过大的情况下有较严重的全身及局部毒性作用。Objective To study the effects of penicillamine on the prevention of intra-abdominal adhesion and healing of small-intestine stoma and abdominal wall as well as to observe the side effects of penicillamine. Methods Sixty Wistar rats were randomly divided into five groups. The abdomens of the rat were opened and the small intestines were cut lengthways and closed breadthwise. Each group was given different treatments. The grades of healing and intra-abdominal adhesion were recorded and the wound breaking strength of abdominal walls and the wound bursting strength of small intestines measured. Samples of each group were stained with HE and immunohistochemical methods. Results The integral of intra-abdominal adhesion and the wound breaking strength of abdominal walls in experimental groups decreased obviously compared with the control group. But all wounds healed well. There were no leakages in the anastomosis of small intestines. The wound bursting strength of small intestines was higher than the normal small intestines. The amount of capillary vessel, fibroblast and collagen in samples of small intestines and abdominal walls in the experimental groups decreased markedly compared with the control group. Conclusion Penicillamine can effectively prevent the formation of intra-abdominal adhesion and reduce the wound breaking strength. It has no effect on the wound bursting strength of small intestines. Penicillamine has severe side effects and toxicity in high doses.

关 键 词：青霉胺 腹腔 粘连 切口愈合 

分 类 号：R977[医药卫生—药品]