铜绿假单胞菌注射液对术后早期腹腔化疗时结肠吻合口愈合的影响

Effect of pseudomonas aeruginosa injection on the healing of colon anastomoses during early postoperative intraperitoneal chemotherapy

目的考察铜绿假单胞菌注射液(PA-MSHA)对术后早期腹腔化疗时结肠吻合口愈合的影响。方法 SD大鼠60只随机分为3组:A组,术后1～5 d腹腔注射生理盐水0.8 mL/(kg.d);B组,术后1～5 d腹腔注射氟尿嘧啶20 mg/(kg.d);C组,术前第3天开始皮下注射PA-MSHA 0.5 mL/次,隔日一次,直至实验结束,术后腹腔化疗方法同B组。术后第7和14天检测各组大鼠的一般情况、吻合口漏发生率、血淋巴细胞计数、吻合口破裂压力(ABP)、吻合口羟脯氨酸含量(HYP)和吻合口病理组织学指标。结果 B组吻合口漏发生率为30.0%,其他两组均为0(P<0.05);术后第7天,B组血淋巴细胞计数、ABP、HYP、Ⅰ型和Ⅲ型胶原含量显著低于A组和C组(P<0.05);术后第14天,除C组血淋巴细胞计数明显高于A组和B组(P<0.05)外,其他指标无显著性差异。结论应用PA-MSHA能减轻化疗药物毒副反应,促进术后早期腹腔化疗情况时结肠吻合口的愈合。

Purpose To investigate the effect of pseudomonas aeruginosa injection（PA-MSHA）on the healing of colon anastomoses during early postoperative intraperitoneal chemotherapy.Methods Sixty SD rats were randomly divided into 3 groups.A group,intraperitoneal injection of normal saline 0.8 mL/（kg·d）,within 5 days after surgery,B group,intraperitoneal injection of 5-fluorouracil 20 mg/（kg·d）,within 5 days after surgery,and C group,subcutaneous injection of PA-MSHA,0.5 mL,qod,from 3 days before surgery until the end of experiment.The regimen of intraperitoneal chemotherapy was identical to that of B group.10 rats of each group were sacrificed respectively on day 7 and day 14 and the protocol-designed indicators were detected including general state,anastomotic leakage rate,peripheral blood lymphocyte count,anastomotic bursting pressure（ABP）,hydroxypoline content（HYP）and hestopathology.Results The rate of anastomotic leakage was 30% for B group,while 0% for A group and C group（P0.05）.On the 7th day after surgery,the peripheral blood lymphocyte count,ABP,HYP,type I and type Ⅲ collagen for 5-Fu group count was significantly lower than that for A and C group（P0.05）.On the 14th day after surgery,the peripheral blood lymphocyte count for C group was significantly higher than that of A and B group（P0.05）,while there were no statistical data of other indicators among the three groups.Conclusion PA-MSHA can reduce the toxicity of chemotherapy and promote colonic anastomotic healing under the condition of early postoperative intraperitoneal chemotherapy.