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[1]吴伟航,林志雄,林楠,等.快速肠管重建在大鼠肠管断裂伴失血性休克中的应用研究[J].医学研究与战创伤救治(原医学研究生学报),2019,21(3):225-228.[doi:10.3969/j.issn.1672-271X.2019.03.001]
　WU Wei-hang,LIN Zhi-xiong,LIN Nan,et al.Application study of temporary quick intestinal remodeling in rat intestinal rupture with hemorrhagic shock[J].JOURNAL OF MEDICALRESEARCH —COMBAT TRAUMA CARE,2019,21(3):225-228.[doi:10.3969/j.issn.1672-271X.2019.03.001]
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快速肠管重建在大鼠肠管断裂伴失血性休克中的应用研究()
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《医学研究与战创伤救治》（原医学研究生学报）[ISSN:1672-271X/CN:32-1713/R]

卷:
第21卷
期数:
2019年3期
页码:
225-228
栏目:
出版日期:
2019-05-10

文章信息/Info

Title:
Application study of temporary quick intestinal remodeling in rat intestinal rupture with hemorrhagic shock
文章编号:
1672-271X（2019）03-0225-04
作者:
吴伟航; 林志雄; 林楠; 杨为锦; 蔡志聪; 林丽; 方永超; 林晨; 王瑜
作者单位：350025 福州,解放军联勤保障部队第九OO医院普外科（吴伟航、林 楠、杨为锦、林 晨、王 瑜）；350025 福州,福建医科大学福总临床医学院（第九OO医院）（林志雄、林 丽）；362200 晋江，晋江市医院普外科（蔡志聪）；350025 福州,厦门大学附属东方医院（第九OO医院）普外科（方永超）
Author(s):
WU Wei-hang1;  LIN Zhi-xiong2;  LIN Nan1;  YANG Wei-jin1;  CAI Zhi-cong3;  LIN Li2;  FANG Yong-chao4;  LIN Chen1;  WANG Yu1
1.Department of General Surgery，the 900th Hospital of the Joint Logistics Team，Fuzhou 350025，Fujian,China； 2.Clinical Institute of Fuzhou General Hospital,Fujian Medical University，Fuzhou 350025,Fujian,China;3.Department of General Surgery，Jinjiang Municipal Hospital，Jinjiang 362200,Fujian, China;4.Department of General Surgery，Dongfang Hospital，Xiamen University，Fuzhou 350025，Fujian,China
关键词:
损伤控制手术;  肠管损伤;  肿瘤坏死因子;  白细胞介素
Keywords:
damage control surgery;  intestinal injury;  tumor necrosis factor;  interleukin
分类号:
R6
DOI:
10.3969/j.issn.1672-271X.2019.03.001
文献标志码:
A
摘要:
目的 比较快速暂时性肠管重建与传统的肠管断端结扎方法对大鼠肠管断裂伴失血性休克的救治疗效，探索更加合理、有效的损伤控制性手术方法。 方法 将20只达到失血性休克状态的SD大鼠按随机数字表法分为2组，结扎组（n=10）采用肠管断端丝线结扎方法，重建组（n=10）采用自主研制肠道重建套管进行肠道连续性重建，于术后12 h、24 h取眼内眦静脉血离心测定2组大鼠血清中肿瘤坏死因子α（TNF-α）和白细胞介素6（IL-6）水平，24 h后取2组肠道中间5 mm肠管组织，标本固定后用光学显微镜观察其组织形态及炎症浸润程度。 结果 与重建组比较，结扎组大鼠术后12 h血清中IL-6水平[（152.20±16.24）ng/L vs (217.28±19.23) ng/L]及24 h血清中TNF-α和IL-6水平[（117.56±15.78）ng/L vs (258.60±21.65) ng/L，（173.78±8.58）ng/L vs (341.07±49.52) ng/L]显著升高（P<0.01）。组织病理观察到结扎组肠黏膜上皮结构破坏，大量炎症细胞浸润；重建组肠黏膜上皮结构完整，黏膜下层仅少量炎症细胞浸润。 结论 在肠管断裂伤中，与肠管断端结扎相比，暂时性肠管重建可以有效减轻机体的炎症、保护肠黏膜屏障，有望成为新的损伤控制性手术处理措施。
Abstract:
Objective To compare the effect of temporary intestinal quick reconstruction and the traditional way of ligating the ends of intestine in intestinal rupture of rats，and explores a more reasonable and effective method of damage control operation. Methods Twenty SD rats with hemorrhagic shock were randomly divided into two groups.The ligation group (n=10) was treated with a silky ligation method.The reconstructed group (n=10) was performed with the self-developed intestinal reconstruction cannula for intestinal continuous reconstruction.The intracanthus venous blood was centrifuged at 12 h and 24 h after surgery，and the levels of tumor necrosis factor alpha （TNF-α） and interleukin 6（IL-6）levels in the serum of the two groups were determined.After 24 h，5 mm segments of middle intestinal were removed from each rat’s，and tissue morphology and inflammatory infiltration were observed by optical microscope after fixation. Results Compared with the reconstruction group, the serum levels of IL-6 after 12 h[(152.20±16.24) ng/L vs (217.28±19.23) ng/L] and the levels of TNF-α and IL-6 after 24 h [(117.56±15.78) ng/L vs (258.60±21.65) ng/L, (173.78±8.58) ng/L vs (341.07±49.52) ng/L] in ligation group increased significantly(P<0.01).Histopathology showed that the structure of intestinal mucosal epithelial destruction and a large amount of inflammatory cells infiltrated in the ligation group; the intestinal mucosal epithelial structure in the reconstruction group was complete and there are only few inflammatory cells infiltrated in the submucosa. Conclusion In the rupture of the intestinal tract，temporary bowel reconstruction can effectively reduce the inflammation of the body and protect the barrier of the intestinal tract compared with the ligation of the intestine.And it is expected to become a new damage control surgical treatment.

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备注/Memo

备注/Memo:
收稿日期：2018-11-22
更新日期/Last Update: 2019-05-10