腹膜透析液术后灌洗对腹腔粘连预防作用  

作　　者：尹大伟 

机构地区：[1]长春市翔运街第二医院,130062

出　　处：《当代医学》2009年第2期58-60,共3页Contemporary Medicine

摘　　要：目的探讨腹腔手术后应用腹膜透析液腹腔灌洗和持续灌洗对腹腔粘连的影响。方法大鼠30只,随机分为A、B、C三组,每组10只,先行均制成肠粘连模型。A组设为对照组,B组为术后大剂量灌洗组300m1/kg,C组术后连续灌洗5天,1次/日,每次约40ml,术后10天处死动物,观察各组腹腔粘连情况。最后所得数据经统计学检验,彩色摄影记录腹腔内粘连情况,粘连组织送光镜检查。结果与对照组比较,B组、C组均能降低术后肠粘连的程度(p<0.01)。但C组作用优于B组,组间比较有显著性差异(p<0.01)。结论腹膜透析液术后腹腔灌洗,具有减轻、预防术后肠粘连的作用,且不会发生酸碱平衡及电解质紊乱,无腹水发生。无凝血障碍及过敏反应。短期应用未产生化学性腹膜炎,术后持续灌洗效果更佳。Backgrounds： Postoperative adhesive intestinal obstruction is a common ＇and intractable problem. The incidence of postoperative intestinal obstruction in abdominal cavity is up to 80-90%, and abut 30% of them is adhesive. It means a lot of pain and cost that patient should suffer from. Although many medicines can play some roles, there is still one recognized method is available for prevention of adhesion in abdominal cavity. Peritoneum is considered available prophylactic tissue in abdominal cavity, and it is abundant in macrophage and neutrophil. Any stimulates can activate these cells in the course of operation, so a series of cellular immune responses occur. As a result, some cytokines and inflammatory mediators occur, such as： TNF, transforming growth factor, LTs, and so on. To induce tissues inflammatory immune response is the beginning of the adhesion. To rinse abdominal cavity with aseptic normal saline, and clear out eyewinker, and bleeding and perfusion, including the cytokines, inflammatory mediators, to dilute local fiber protein density, and hydrate float effect, it will alleviate the intestines adhesive degree. Peritoneum dialysis has the same effect. The result of postoperative persist lavage is much better, also it can avoid the disturbance of water and electrolyte, no ascites occur, or hemostactic obstacle and hypersusceptibility response. Objective： to investigate the effect of postoperative using peritoneum dialysis abdomen la,~age and persistent la^age on abdomen adhesive. Methods： 30 rats were randomly divided into 3 groups and antecedence to make intestine adhesive models. A： normal group, B： great dosage lavlage group 300ml/kg, C： group persistent lavage for 25-30ml per time once a day in 5 days. The rats were killed after 10 days, observe the situation of abdomen adhesive situation. Using statistics method to testify the data, tract record with digital camera, using microscope to verify the adhesive tissue. Results： contrary to the normal control group Band Cgroup can bot

关 键 词：腹膜透析液 腹腔粘连 预防作用 术后灌洗 术后肠粘连 化学性腹膜炎 持续灌洗 腹腔灌洗 

分 类 号：R656[医药卫生—外科学]