两种电凝对大鼠胃溃疡模型的热损伤及止血效果的实验研究  

Experimental study on thermal injury and hemostatic effect of two kinds of electrocoagulation in rat gastric ulcer model

作　　者：段惠春 蒲华云 周鑫 祝杰 施竹君 马莉 张丽华 李佳悦 DUAN Huichun;PU Huayun;ZHOU Xin;ZHU Jie;SHI Zhujun;MA Li;ZHANG Lihua;LI Jiayue(Department of Gastroenterology,Gansu Gem Flower Hospital,Lanzhou 730060,China;Department of Pathology,Gansu Gem Flower Hospital,Lanzhou 730060,China)

机构地区：[1]甘肃宝石花医院消化科,甘肃兰州730060 [2]甘肃宝石花医院病理科,甘肃兰州730060

出　　处：《胃肠病学和肝病学杂志》2023年第2期165-169,共5页Chinese Journal of Gastroenterology and Hepatology

基　　金：甘肃宝石花医院科研项目(GSBSHYY-2021-02)。

摘　　要：目的 通过给大鼠灌注无水乙醇诱发胃溃疡出血模型后,观察柔和电凝与普通电凝对大鼠胃溃疡组织的热损伤程度及止血效果。方法 选取50只SD大鼠,均达到SPF级标准,随机分为三组,即空白组(n=5)、模型组(n=5)、实验组(n=40),后者再分为柔和电凝组(n=20)和普通电凝组(n=20)。用无水乙醇诱发大鼠胃溃疡出血后,实验组大鼠分别用柔和电凝和普通电凝对大鼠的胃溃疡面进行3 s、5 s、8 s电凝后,沿溃疡面周围1 cm切除溃疡及部分正常胃壁组织,用4%甲醛将胃组织固定后,经包埋及切片和染色后,光镜下观察溃疡周围热损伤程度及组织病理学改变。模型组予以无水乙醇灌胃观察胃溃疡造模是否成功,空白组未予特殊处理。结果 大鼠胃溃疡组织热损伤程度普通电凝大于柔和电凝,差异有显著统计学意义(P<0.01)。普通电凝治疗后大鼠病理切片见大鼠胃组织凝固后形成大量焦痂,周围组织损伤程度重,焦痂脱落后容易导致再出血、甚至穿孔。而柔和电凝治疗后胃组织周围不形成焦痂,周围组织损伤轻。结论 普通电凝止血后对胃溃疡周围组织热损伤程度重,而柔和电凝对周围组织热损伤程度轻,止血疗效好,避免了术后再出血。Objective To observed the degree of thermal injury and hemostatic effect of mild electrocoagulation and ordinary electrocoagulation on gastric ulcer tissue of rats after the model of gastric ulcer bleeding was induced by anhydrous ethanol. Methods Fifty SD rats were randomly divided into three groups: blank group(n=5), model group(n=5) and experimental group(n=40). The latter group was further divided into mild electrocoagulation group(n=20) and normal electrocoagulation group(n=20). After gastric ulcer bleeding was induced by anhydrous alcohol, rats in the experimental group were treated with mild electrocoagulation for 3 seconds, 5 seconds and 8 seconds respectively, after electrocoagulation, the ulcer and part of normal gastric wall tissue were resected along 1 cm around the ulcer surface. The gastric tissue was fixed with 4% formaldehyde, embedded, sectioned and stained, and the degree of thermal injury and the change of histopathology around the ulcer were observed under light microscope. The model group was given anhydrous alcohol to observe the success of gastric ulcer model, the blank group was not given special treatment. Results The degree of thermal injury of gastric ulcer tissue in rats was higher with electrocoagulation than with mild electrocoagulation, the difference was significant(P<0.01). The pathological sections of rats after electrocoagulation showed a lot of eschar formed after gastric tissue coagulation, and the surrounding tissues were damaged seriously. However, eschar did not form around the gastric tissue after mild electrocoagulation, and the injury of the surrounding tissue was slight. Conclusion The heat injury of gastric ulceris serious after the ordinary electrocoagulation hemostasis, but the mild electrocoagulation has less heat injury and good hemostasis effect, avoiding the bleeding after the operation.

关 键 词：柔和电凝 普通电凝 胃溃疡出血 热损伤 大鼠 

分 类 号：R573[医药卫生—消化系统]