预防性回肠造口联合盆腔冲洗引流对大鼠直肠吻合口愈合的影响

Effect of defunctioning ileostomy with early pelvic irrigation on the anastomosis of the rectum in rats

目的探讨预防性回肠造口联合盆腔引流对大鼠直肠吻合口愈合的影响。方法 60只大鼠随机分为观察组、肠造口组、非肠造口组和肠瘘组,术后3d、7d和10d为观察时间点,每个时间点各5只大鼠。观察术后大鼠腹腔粘连、吻合口破裂压、组织羟脯氨酸含量和组织HE染色、Van Gieson染色等的变化。结果在各时间点,观察组、肠造口组和肠瘘组大鼠术后腹腔粘连致密,而非肠造口组较轻;观察组的吻合口破裂压和组织羟脯氨酸含量分别与肠造口组和非肠造口组比较均无明显差异(P>0.05),但明显高于肠瘘组(P<0.05);HE染色和Van Gieson染色显示:肠瘘组吻合口炎症反应重,观察组最轻,后者胶原最多,肠瘘组较少。结论预防性回肠造口联合盆腔引流可能并不能促进大鼠直肠吻合口的愈合。

Objective To investigate the role of defunctioning ileostomy with early pelvic irrigation on the anastomosis of the rectum in rats.Methods 60 rats were randomized into observation group,ileostomy group,non-ileostomy group and anastomotic leakage group;Each group was observed in the time points in 3 days,7 days and 10 days after surgery,each time point 5 rats.Post-operative intra-peritoneal adhesion in rats,anastomotic bursting presure,hydroxyproline content,anastomotic tissues HE staining and Van Gieson staining were analyzed in different time points.Results In different time points after surgery,Post-operative intra-peritoneal adhesion in those rats of observation group,ileostomy group and anastomotic leakage group was extensive and dense,while in non-ileostomy group,the abdominal adhesion was mild.At the same time point,anastomotic bursting presure and hydroxyproline content of the observation group were not significantly different from that of the ileostomy group and the non-ileostomy group(P>0.05),but significantly higher than that of the anastomotic leakage group(P<0.05).In the anastomosis with HE staining and Van Gieson stainin,the local inflammation in the anastomotic leakage group was serious,but that of the observation groups mild;and the collagen content in the observation groups was most,while that of the anastomotic leakage group less.Conclusion Defunctioning ileostomy with early pelvic irrigation cannot make the healing of rat rectal anastomosis.