胃肠道浆肌层吻合的可行性研究  

Experimental studies on seromascular layer anastomosis of gastrointestinal tract in rabbits

作　　者：黄从云[1] 彭淑牖[1] 李江涛[1] 赵之明[1] 薛建峰[1] 刘付宝[1] 孙菊妹[1] 

机构地区：[1]浙江大学附属第二医院普外科

出　　处：《中华实验外科杂志》2006年第11期1381-1383,共3页Chinese Journal of Experimental Surgery

摘　　要：目的探讨胃肠道浆肌层吻合的可行性。方法中国家兔分成4组,A组(浆肌层吻合)、B组(二层吻合)、C组(一层吻合)和D组(黏膜外吻合),每组10只。每只动物行胃十二指肠侧侧吻合、回肠端端吻合(2个)和结肠端端吻合(2个)。术后测定吻合破裂压、组织羟脯氨酸含量和组织病理学检查。结果(1)术后第3天,A组胃肠道吻合的吻合破裂压、羟脯氨酸含量与B、C、D组差异无统计学意义；(2)第7天,A组吻合破裂压在胃十二指肠吻合中高于B、C组(P＜0．05),回肠吻合中高于B组(P＜0．01),结肠吻合中高于B、C、D组(P＜0．05)；胃十二指肠吻合组织羟脯氨酸含量A组高于B组(P＜0．05),和C、D组差异无统计学意义；(3)A组的炎症反应在胃十二指肠吻合中与B、C、D组相似,回肠吻合中最轻,结肠吻合中与B组相似。结论胃肠道浆肌层吻合是一种安全、可靠,简便的吻合方法。Objective To explore the feasibility of seromuscular layer anastomosis of gastrointestinal tract in rabbits. Methods Chinese rabbits were divided into 4 groups：group A （seromuscular layer anastomosis, n = 10）, group B （ double-layer inverted anastomosis, n = 10）, group C （single-layer inverted anastomosis, n = 10） and group D （extramucosal anastomosis, n = 10）. Five anastomoses were performed on each animal ,one in side-to-side gastroduodenal anastomosis, two in end-to-end ileal and colonic anastomoses respectively. Half of each group was sacrificed on the postoperative day 3 and 7 to determine in situ anastomotic bursting pressures, hydroxyproline contents and histopathological evaluation of the anastomotic sites. Results （ 1 ） On the day 3, anastomotic bursting pressure and hydroxyproline content in group A were not significantly different from groups B, C and D; （2） On the day 7, bursting pressure showed no significant difference among groups B, C and D for gastroduodenal, ileal and colonic anastomoses, but dramatically higher in group A than in groups. B and C [ （200.4 ± 19.4） vs （ 144.0 ± 30.8）, （ 144.8 ± 42.4） cm H20, P 〈 0.05, respectively] in gastroduodenal anastomosis, and group B [ （217.6 ± 30.8） vs （149.4± 14.7） cm H2O, P〈 0.01] in ileal anastomosis, and also groups B, C and D [ （306.2 ± 47.5 ） vs （234.0 ± 33.7 ）, （250.0 ± 50.1 ）, （247.6 ± 32.1 ） cm H2O, P 〈 0.05, respectively] in colonic anastomosis. Hydroxyproline content was higher in group A than in group B in gastroduodenal anastomosis on the day 7 （ 1 015.7 ±99.6） vs （616.5 ±87.9） μg/g tissue wet weight, P 〈 0.05 ] ; （3） Histological examination of the anastomoses showed that the inflammatory reaction of the gastrointestinal wall had no differences among the 4 groups in gastroduodenal anastomosis, but decreased in group A in ileal anastomosis as compared with groups B,C and D on the day 3 and 7. For colonic anastomosis, the profound inflammatory reaction

关 键 词：胃肠道 浆肌层 吻合 羟脯氨酸 

分 类 号：R656.6[医药卫生—外科学]