胆道电灼伤自我修复过程的病理改变

THE PATHOLOGICAL CHANGES IN SPONTANEOUS HEALING PROCESS OF BILIARY TRACT ELECTRICAL BURNS

目的调查一定强度一定时间一定部位的电凝后,胆管组织自我修复的病理过程,为术中即时修复胆管电灼伤提供理论和动物实验中的依据。方法将40只新西兰白兔用随机数字表法均分成电灼后1周组、2周组、4周组、8周组和假手术组。高频手术器20 W功率电凝1 s,取各时间点胆管做HE染色并进行观察和分析。结果第1周内为修复过程的炎症期,第1周至第4周内为修复过程的组织形成期,第4周内至第8周为修复过程的组织塑性期。除假手术组外各组距电灼点2.5 mm、5 mm、7.5 mm处均有病理改变。结论肝外胆管电灼伤实际损伤范围远大于肉眼所见。肝外胆管电灼伤自我修复进程远慢于普通手术切口愈合进程。胆管上皮细胞的增殖、分化对胆管电灼伤的自我修复起到关键的作用。

Objective To investigate certain period of time, certain parts, and certain intensity of electric coagulation caused bile duct bums by ordinary light microscope, including the extent and scope of damage, the pathological process of self-repair. This animal experiments provide some theoretical basis for the immediate repair of intraoperative bile duct electrical bums. Methods The 45 New Zealand white rabbits were randomly divided into 1 week, 2 weeks, 4 weeks, 8 weeks group after cauterization and sham operation group. 20W power high-frequency electric coagulation surgical unit worked 1 s. Did HE staining of bile duct and then made observation and analysis. Results The inflammation phase of repair process occurred in the first week; The proliferative phase of repair process was from the 1 st week to the 4th week; The remodeling phase of repair process was from the 4th week to 8th week. From the electrocautery point 2. 5 ram, 5 mm, 7.5 mm, vary degrees of bile duct pathological changes occurred in all groups except normal group. Conclusion The actual damage range of electrical bums of extrahepatic bile duct is much larger than the naked eye found. Extrahepatic bile duct electrical bums self-repair process is much slower than normal wound healing process. The proliferation and differentiation of bile duct epithelial cell play a key role in self-repair of bile duct electrical bums.