局部植入化疗对结肠吻合口愈合的影响  

Effect of Mesentery Imbedding Chemotherapy on The Healing of Colonic Stoma in Dog

作　　者：朱雯怡[1] 范跃祖[2] 阎波[1] 包炎毅[1] 侯坤[1] 

机构地区：[1]上海市浦南医院普外与腔镜外科,上海200125 [2]同济大学附属同济医院普外科,上海200065

出　　处：《中国普外基础与临床杂志》2007年第2期192-195,共4页Chinese Journal of Bases and Clinics In General Surgery

摘　　要：目的探讨犬肠系膜植入缓释5一氟尿嘧啶（5-FU）对结肠吻合口愈合的影响。方法成年健康杂种犬28只，按随机数字法随机分为对照组（6只）和实验组（22只）。手术经腹正中切口行乙状结肠中段离断再吻合，将缓释5-FU200mg单点植入到距离肠吻合口1．0～1．5cm肠系膜处。对照组植入5-FU对照品。分别于植药后3、5、7、10及15d各处死4只动物，取肠系膜及吻合口组织行病理学检查，观察肠吻合口愈合的情况，并采用高效液相色谱法分别检测不同时相吻合口处及距植药点0、1、3、5、7、10及15cm处组织药物浓度。结果药物植入后3d，吻合口组织仅为炎症表现，未见明显的坏死、细胞变形等病理表现；植入后第10d，吻合口组织基本恢复正常。距植入点0～15cm范围内，各点组织药物浓度随距离及时间延长依次递减，但均高于抑瘤浓度（0．10μg／g）。结论结肠吻合口旁肠系膜植入缓释5-FU，对吻合口愈合无影响；局部植入缓释5-FU能在一定时间内维持较高的有效药物浓度。Objective To investigate the effect of imbedding chemotherapy of sustained release of 5-fluorouracil on the healing of colonic stoma in dog. Methods Twenty-eight adult hybrid dogs were randomly divided into chemotherapy group （n=22） and control group （n=6）. The canine sigmoid colon were firstly detached and then anastomosed via median abdominal incision, 200 mg sustained release of 5-fluorouracil was imbedded in the mesentery 1.0-1.5 cm away from colonic stoma in chemotherapy group, whereas the control substance was injected into the dogs in control group. Tissue samples were collected from mesentery and stomas on 3, 5, 7, 10 and 15 days after operation, respectively, in order to observe the healing of stoma. The drug concentrations in the stoma and in the tissues that were 0, 1, 3, 5, 7, 10 and 15 cm away from the imbedding point were also measured by high performance liquid chromatography method at different phases. Results The tissues from colonic stoma only showed inflammatory reaction at early stage, with no necrosis and cellular degeneration. It was observed that the stoma healed basically on the tenth day after operation. The drug concentrations in the tissues gradually decreased at the range of 0-15 cm over time, but all of which were higher than the anti-tumor effective concentration （0.10 μg/g）. Conclusion The imbedding chemotherapy of sustained release of 5-fluorouracil in mesentery has little effect on the healing of stoma, and it could remain an effective anti-tumor concentration in a period of time.

关 键 词：植入化疗 缓释5-氟尿嘧啶 病理学 药物浓度 犬 

分 类 号：R735.3[医药卫生—肿瘤]