十二指肠造瘘术治疗犬急性出血坏死性胰腺炎研究

The Therapeutic Effect of Duodenostomy on Acute Hemorrhagic Necrotizing Pancreatitis in dogs

目的 :研究十二指肠造瘘术对犬急性出血坏死性胰腺炎 (AHNP)的治疗价值。方法 :制作犬AHNP模型 ,并行十二指肠造瘘术 ,2 4h后随机开放一半动物的十二指肠造瘘管 ,为实验组 ,另一半未开放者为对照组。犬存活 72h后立即在无菌条件下开腹 ,取腹腔液、胰腺坏死组织、十二指肠液作细菌培养。结果 :实验组存活率高于对照组。两组腹腔液、十二指肠液细菌培养无明显差异 ,但实验组胰腺坏死组织的感染率明显低于对照组 (P <0 .0 5 )。结论 :十二指肠造瘘术可以防治AHNP时胰腺组织的细菌感染 。

Objective The experiment was designed to investigate the therapeutic effectiveness of duodenostomy in acute hemorrhagic necrotizing pancreatitis (AHNP). Methods Dogs were randomly divided into two groups ,an open group and a closed group.Dog model of AHNP was induced by intrapancreatoductal injection of autologous fresh bile trypsin mixture,and then a tube duodenostomy was established.24 h after AHNP induction,the duodenostomy tubes was opened in the open group,and clamped in the closed group.72 h after AHNP induction,exudant from the abdominal cavity,necrotic pancreas or nonviable tissue and duodenal fluid were collected from both of the groups and cultured for bacteria.Results The survival rate of the closed group was significantly higher than that of the open group.No difference was found in the culture of exudant from the abdominal cavity and duodenal fluid from the two groups,but the infection rate of necrotic pancreas in the open group was significantly lower than that in control.Conclusion Duodenostomy may reduce the infection rate and has an obvious therapeutic effectiveness in AHNP.