新型早产猪短肠综合征模型的建立

Establishment of Novel Premature Piglet Models for Short Bowel Syndrome

目的探讨新的早产猪短肠综合征模型的建立方法。方法将32头早产猪按随机号码表法分成空肠回肠吻合组、空肠结肠吻合组、假手术组及空白对照组4组,每组8头小猪。空肠回肠吻合组:切除75%的小肠,保留近端空肠(占总小肠长度的10%)和远端回肠(占总小肠长度的15%),并行空肠回肠吻合;空肠结肠吻合组:切除75%的小肠,包括远端空肠(占总小肠长度的25%)、全部回肠(占总小肠长度的50%)、回盲瓣和回盲瓣以远5 cm的结肠,保留近端空肠(占总小肠长度的25%),行空肠结肠吻合;假手术组:在距回盲瓣以近25 cm处行回肠完全横断并重新吻合;空白对照组:未行手术。比较4组小猪的术后第1次排便时间、腹泻时间、PN时间、小肠长度、小肠重量、结肠重量、空肠绒毛高度和陷窝深度以及回肠绒毛高度和陷窝深度。结果与假手术组和空白对照组比较,空肠回肠吻合组及空肠结肠吻合组术后21 d的空肠和回肠绒毛高度及陷窝深度均较长(P<0.050),显示了充足的肠适应的解剖学证据;但空肠结肠吻合组术后依赖PN时间较空肠回肠吻合组长(P<0.050),且术后21 d时,空肠结肠吻合组的小肠长度、重量以及结肠的重量均较空肠回肠吻合组低(P<0.050),提示空肠结肠吻合组小肠的肠适应能力较空肠回肠吻合组低。结论空肠回肠吻合和空肠结肠吻合法建立早产猪短肠综合征模型有着不同的肠适应程度和生长情况,可用于短肠综合征的实验研究,其中以空肠回肠吻合法较为理想。

Objective To explore a new method for establishing premature piglet model of short bowel syndrome. Methods Thirty two premature piglets were randomly divided into 4 groups, including jejunoileal anastomosis group, jejunocolic anastomosis group, sham operation group, and blank control group. Each group enrolled 8 premature piglets. jejunoileal anastomosis group： resected 75% of small intestinal, reserved the proximal jejunum （10% of the total small intestine length） and distal ileum （15% of the total small intestine length）, with jejunoileal anastomosis. Jejunocolic anastomosis group： removed 75% of the small intestine, including the distal jejunum （25% of the total small intestine length）, total ileum （50% of total small intestine length）, the ileocecal valve, and the colon beyond 5 cm far from the ileocecal valve, retained the proximal jejunum （25% of the total length of the small intestine）, with jejunocolic anastomosis. Sham group： cut off the ileum at a distance of nearly 25 cm of the ileocecal valve ileum, then anastomosed the intestine again. Blank control group： no surgery. Data included the first defecation time, duration of diarrhea and parenteral nutrition （PN） after surgery, the length and weight of the small intestine, the weight of the colon, the villus height and crypt depth of both jejunum and ileum at 21st days postoperatively, were collected and analysed. Results Compared with the sham group and blank control group, jejunoileal and jejunocolic anastomosis groups showed higher villus height and the crypt depth of jejunum and ileum （P〈0.050）, provided enough anatomy evidence of intestinal adaptation. However, the duration ofPN in jejunocolic group was longer than in jejunoilea anastomosis group （P〈0.050）. The length and weight of the small intestine and the weight of colon in jejunocolic anastomosis group, were lower than in jejunoileal anastomosis group （P〈0.050）, improving that the ability of intestinal adaptation of jejunocolic anastomosis was better than the jejunoileal anastomosis group. Conclusions Premature piglet models of short bowel syndrome could be established by methods of jejunoileal and jejunocolic anastomosis. Both of the methods had their own different degree of intestinal adaptation and growth. The jejunoileal anastomosis is maybe a better way to establish this model.