氟尿嘧啶缓释剂对兔胆肠吻合口愈合影响的研究  

Influence of sustained-release fluorouracil implants on healing of bilioenteric anastomosis in rabbits

作　　者：方征[1] 史嵩[2] 张永杰[2] 

机构地区：[1]中国人民解放军第一〇一医院普通外科,江苏无锡214044 [2]中国人民解放军第二军医大学东方肝胆外科医院胆道二科,上海200438

出　　处：《中国普通外科杂志》2014年第2期192-197,共6页China Journal of General Surgery

摘　　要：目的:探讨氟尿嘧啶缓释剂对兔胆肠吻合口组织愈合的影响,为其临床应用的可行性及安全性提供依据。方法:40只健康新西兰兔随机均分为实验组与对照组,两组均行胆管十二指肠侧侧吻合后,实验组于胆肠吻合口旁植入氟尿嘧啶缓释剂,对照组植入空颗粒。两组于术后3、7、14、21 d取胆肠吻合口组织,观察腹腔内及吻合口大体情况,行van der Ham粘连评分,测定吻合口破裂压(ABP),行吻合口组织病理学及胶原结缔组织检测。结果:实验组存活18只,1只死于胆汁漏,1只死于腹腔感染;对照组存活19只,1只死于胆汁漏,两组死亡率差异无统计学意义(P>0.05)。两组吻合口大体愈合情况相似,术后各时间点van der Ham评分与ABP差异均无统计学意义(均P>0.05)。组织病理学检测(HE染色及Mallory三色法)显示两组术后吻合口周围炎症反应、新生毛细血管和胶原纤维增生情况基本相似。结论:氟尿嘧啶缓释剂不影响兔胆肠吻合口的愈合,可作为预防和治疗胆胰恶性肿瘤术后局部复发和转移的一种安全的辅助化疗手段。Objective： To investigate the influence of sustained-release fluorouracil implants on the healing process of the bilioenteric anastomosis in rabbits, so as to provide data related to the safety and feasibility of its clinical application. Methods： Forty healthy New Zealand rabbits were equally randomized into experimental group and control group. Rabbits in both groups underwent bilioenteric anastomosis, and those in experimental group received sustained-release fluorouracil implantation near the anastomotic stoma, while those in control group received the empty granules instead. In both groups, the tissues around the anastomotic site were harvested on postoperativeday （POD） 3, 7, 14, 21 d respectively, and the general conditions of the abdominal cavity and anastomotic stoma were observed, van der Ham adhesion scoring for the anastomotic stoma was performed, the anastomotic bursting pressure （ABP） was measured, and the histopathological the anastomotic stoma were examined. changes and collagenous connective tissues at Results： In experimental group, 18 rabbits survived, one died of postoperative bile leakage and one died of abdominal infection; 19 rabbits survived in control group and one died of bile leakage, and there was no statistical difference in mortality between the two groups （P〉0.05）. The general healing statuses of the two groups were similar, and there was no significant difference in van der Ham score or ABP at each time point between the two groups （all P〉0.05）. The histopathological examinations （HE staining and Mallory＇s trichrome staining） demonstrated that the two groups showed a similar pattern regarding the infammatory reactions, neovascularization, and collagen fiber hyperplasia around the anastomotic stoma after operation. Conclusion： Sustained-release fluorouracil implant exerts no obvious influence on the healing process of the bilioenteric anastomosis in rabbits, so it can be used as a safe ad）uvant chemotherapeutic method for prevention and

关 键 词：胆管肠吻合术 吻合口 伤口愈合 药物植入物 氟尿嘧啶 兔 

分 类 号：R657.4[医药卫生—外科学]