外科黏合剂对胆肠吻合口瘢痕形成的影响  

Influence of the surgical glue on anastomosis scar formation after bilioenterostomy

作　　者：周林斌[1] 郭善禹[1] 张莉[1] 姚德成[1] 孙建民[1] 

机构地区：[1]上海第二医科大学附属第九人民医院外科,上海200011

出　　处：《中国普通外科杂志》2003年第8期597-599,共3页China Journal of General Surgery

摘　　要：目的　探讨外科黏合剂对胆肠吻合口瘢痕形成的影响。方法　将 72条杂种犬随机分为A(OB胶 )组 ,B (OB胶 +T管定期拔除 )组 ,C (FG )组及D (FG +T管定期拔除 )组 ,用外科黏合剂(OB胶或FG )替代缝线进行胆总管空肠Roux en Y吻合 ,置入T管作为内支撑架 ;分别于术后 3周及3 ,6,9,12个月对吻合口瘢痕组织进行生化胶原含量测定 (BCC )。结果　术后 3个月时 ,B组BCC显著高于A组 (P <0 .0 5 ) ,D组高C组P <0 .0 5 ) ;6个月以后 ,A ,B ,C ,D 4组BCC均处于稳定低值 ,差异无显著性 (P >0 .0 5 )。结论　外科黏合剂可促进吻合口愈合 ,减少瘢痕形成 ,加速瘢痕成熟软化 ,是预防胆道术后吻合口狭窄的一种有效措施。Objective To study the influence of the surgical glue on anastomosis scar formation after bilioenterostomy Methods Seventy-two hybrid canines were randomly assigned into group A (OB glue plus persistent T tube stent ), group B (OB glue plus T tube drawn out at different postoperative time), group C ( FG plus persistent T tube stent ) and group D (FG plus T tube drawn out at different postoperative time). The surgical glue (OB glue or FG) was used instead of silk thread in biliointestinal Roux-en-Y anastomosis, and T tube was placed as indwelling stent. The collagen content (BCC) of anastomotic specimen was measured in 3 weeks and 3 , 6 , 9 ,12 months after the operation. Results Three months after the operation, BCC in group B was significantly higher than that in group A (P<0.05), and it was also significantly higher in group D than that in group C (P<0.05). Six months after the operation, BCC held in stable low levels, and had no significant differences in all the 4 groups(P>0.05). Conclusions The surgical glue can promote anastomosis healing with less scar formation, and accelerate scar softening and maturation, which suggests that surgical glue should be effective in the prevention of anastomotic stricture.

关 键 词：外科黏合剂 胆管肠吻合术 吻合术 Roux-en-Y 瘢痕/病因学 

分 类 号：R657.3[医药卫生—外科学] R619.6[医药卫生—临床医学]