结肠液囊管一期修复猪结肠穿孔的研究  

Experimental Study on Colon Sac Duct Repairing Colon perforation

作　　者：王纯忠[1] 黄宗海 沈三弟[3] 史福军[3] 陈飞[3] 李建国[3] 张全安[3] 

机构地区：[1]南方医科大学,广州市515051 [2]珠江医院普外科,广州市510282 [3]广州市第一人民医院普外科,510380

出　　处：《实用医学杂志》2011年第20期3650-3652,共3页The Journal of Practical Medicine

基　　金：广州市医药卫生科技项目(编号:201102A213001)

摘　　要：目的:研究结肠液囊管能否作为一种安全、可靠的新技术对结肠穿孔进行有效的一期修复,尤其是能否在结肠穿孔48～72h以上,腹腔严重感染的环境下有效修复结肠穿孔。方法:将西藏小型猪随机分为两组,处理组与对照组,每组15头,处理组采用结肠液囊管在电视腹腔镜下对结肠穿孔进行一期修补,对照组以传统一期穿孔缝合近段结肠造瘘,二期结肠回纳手术。修补后第7、14、21天检测穿孔愈合情况:比较穿孔部位的爆破压(BP)、愈合部位组织中微血管密度(MD)及羟脯氨酸含量(HC)。结果:处理组15例均顺利完成,无动物死亡,穿孔部位愈合良好,无肠管狭窄及坏死发生。术后第7、14、21天BP处理组均高于对照组(P<0.05);术后第7、14天处理组HC高于对照组(P<0.001),术后第21天两组无显著差异(P=0.139);术后第7天MD处理组高于对照组(P<0.05)。结论:应用结肠液囊管技术一期修复结肠穿孔是安全、可靠且有效。Objective To investigate the colonic sac duct as a safe and reliable new technology for repairing colorectal perforation in severe abdominal infection environment, especially the colorectal perforation happened within 48 to 72 hours or more. Methods Tibet mini pigs were randomly divided into 2 groups（n = 15 in each group ）, the treatment group was repaired with colon sac duct , the control group with traditional suture and colostomy in a proximal colon in 1st stage, and putting colostomy back in 2^nd stage. Aftert the 7^th, 14^th,21^st day , the anastomotie leakage results such as： the bursting pressure （BP）, the tissue microvessel density （MD） and hydroxyproline content （HC） in healing part were detected. Results Colon sac duct could be repaired for perforation successfully without animal deaths , intestinal stenosis and necrosis. The bursting pressure in treatment group was higher than that of the control group at the 7^th, 14^th,21^st day after surgery （P 〈 0.05） ; hydroxyproline contents was higher in treatment group than that of the control group at the 7^th, 14^th day（P 〈 0.001 ）, there was no significant difference between 2 groups at 21^st day （P = 0.139） ; Microvessel density was higher in treatment group than that of the control group at at the 7th day （P 〈 0.05）. Conclusion colon sac duct was a safe,reliable and effective technology of repairing a colon perforation.

关 键 词：肠穿孔 结肠液囊管 一期修复 电视腹腔镜 

分 类 号：R656.9[医药卫生—外科学]