中华胃肠外科杂志
中華胃腸外科雜誌
중화위장외과잡지
CHINESE JOURNAL OF GASTROINTESTINAL SURGERY
2012年
1期
72-75
,共4页
刘靖正%周平红%姚礼庆%徐美东%蔡明琰%钟芸诗%胡健卫%任重%李亮%朱博群
劉靖正%週平紅%姚禮慶%徐美東%蔡明琰%鐘蕓詩%鬍健衛%任重%李亮%硃博群
류정정%주평홍%요례경%서미동%채명염%종예시%호건위%임중%리량%주박군
胃全层缺损%内镜全层切除术%金属夹%动物模型,兔
胃全層缺損%內鏡全層切除術%金屬夾%動物模型,兔
위전층결손%내경전층절제술%금속협%동물모형,토
Gastric full-thickness defect%Endoscopic full-thickness resection%Metallic clip%Enimal model,rabbit
目的 探讨应用金属夹缝合胃全层缺损的可行性、安全性和有效性.方法 48只新西兰大白兔按随机数字表法分为4组,每组12只.在胃体部全层切开直径2 cm的缺损后,第1组不缝合胃壁缺损,第2组用金属夹夹闭胃壁黏膜层,第3组用金属夹夹闭胃壁全层,第4组用3-0丝线缝合胃壁全层.分别于术后第3天和第7天处死各组动物,大体观察创面愈合情况；测定创面爆破压;并取创面组织,行苏木精-伊红染色和Masson染色,评价创面炎性反应及组织纤维增生情况.结果 第1组动物术后34 h内全部死亡,其他各组动物均良好存活,所有存活动物无腹腔内出血和感染表现.第2、3组与第4组相比,手术耗时短[(45.8±1.6) min和(42.5±1.5)min比(48.0±1.4) min,P＜0.05]；第3天创面爆破压低[(36.9±4.6)mm Hg和(39.8±4.1) mm Hg比(50.5±4.2) mm Hg,P＜O.05]；第7天创面爆破压3组间差异无统计学意义[(95.0±7.9) mm Hg、(97.8±6.8) mm Hg和(98.5±7,0) mm Hg,P＞0.05].相同时间点创面劳木精-伊红染色显示金属夹缝合组炎性反应较轻,Masson染色反映创面愈合无明显差别.结论 应用金属夹缝合胃部全层缺损,无论夹闭胃黏膜层或全层组织,均能达到与手术缝线缝合相同的临床愈合效果和质量.
目的 探討應用金屬夾縫閤胃全層缺損的可行性、安全性和有效性.方法 48隻新西蘭大白兔按隨機數字錶法分為4組,每組12隻.在胃體部全層切開直徑2 cm的缺損後,第1組不縫閤胃壁缺損,第2組用金屬夾夾閉胃壁黏膜層,第3組用金屬夾夾閉胃壁全層,第4組用3-0絲線縫閤胃壁全層.分彆于術後第3天和第7天處死各組動物,大體觀察創麵愈閤情況；測定創麵爆破壓;併取創麵組織,行囌木精-伊紅染色和Masson染色,評價創麵炎性反應及組織纖維增生情況.結果 第1組動物術後34 h內全部死亡,其他各組動物均良好存活,所有存活動物無腹腔內齣血和感染錶現.第2、3組與第4組相比,手術耗時短[(45.8±1.6) min和(42.5±1.5)min比(48.0±1.4) min,P＜0.05]；第3天創麵爆破壓低[(36.9±4.6)mm Hg和(39.8±4.1) mm Hg比(50.5±4.2) mm Hg,P＜O.05]；第7天創麵爆破壓3組間差異無統計學意義[(95.0±7.9) mm Hg、(97.8±6.8) mm Hg和(98.5±7,0) mm Hg,P＞0.05].相同時間點創麵勞木精-伊紅染色顯示金屬夾縫閤組炎性反應較輕,Masson染色反映創麵愈閤無明顯差彆.結論 應用金屬夾縫閤胃部全層缺損,無論夾閉胃黏膜層或全層組織,均能達到與手術縫線縫閤相同的臨床愈閤效果和質量.
목적 탐토응용금속협봉합위전층결손적가행성、안전성화유효성.방법 48지신서란대백토안수궤수자표법분위4조,매조12지.재위체부전층절개직경2 cm적결손후,제1조불봉합위벽결손,제2조용금속협협폐위벽점막층,제3조용금속협협폐위벽전층,제4조용3-0사선봉합위벽전층.분별우술후제3천화제7천처사각조동물,대체관찰창면유합정황；측정창면폭파압;병취창면조직,행소목정-이홍염색화Masson염색,평개창면염성반응급조직섬유증생정황.결과 제1조동물술후34 h내전부사망,기타각조동물균량호존활,소유존활동물무복강내출혈화감염표현.제2、3조여제4조상비,수술모시단[(45.8±1.6) min화(42.5±1.5)min비(48.0±1.4) min,P＜0.05]；제3천창면폭파압저[(36.9±4.6)mm Hg화(39.8±4.1) mm Hg비(50.5±4.2) mm Hg,P＜O.05]；제7천창면폭파압3조간차이무통계학의의[(95.0±7.9) mm Hg、(97.8±6.8) mm Hg화(98.5±7,0) mm Hg,P＞0.05].상동시간점창면로목정-이홍염색현시금속협봉합조염성반응교경,Masson염색반영창면유합무명현차별.결론 응용금속협봉합위부전층결손,무론협폐위점막층혹전층조직,균능체도여수술봉선봉합상동적림상유합효과화질량.
Objective To evaluate the feasibility,efficacy,and safety of metallic clips for closure of full-thickness defects in the stomach wall.Methods Forty-eight rabbits were randomly divided into 4 groups with 12 in each group using random digits table.A 2 cm×2 cm full-thickness defect was created in the gastric body.No closure was performed in the first group; in the second group,mucosa closure with metallic clips; the third group,closure of full-thickness gastric tissue with metallic clip; the fourth group closure with 3-0 silk suture.After operation the animals were sacrificed at the third day and the seventh day.Wound healing was evaluated.Bursting pressure was recorded.HE and Masson staining was performed to inspect wound inflammation and tissue fibrosis situation.Results After operation all the animals in the first group died within 34 hours,while those in other groups survived.No intraperitoneal bleeding or infection were seen in the survived animals.General observation showed that the metallic closure group caused less intraperitoneal adhesions.Operative time was shorter in the second and third group compared to the fourth group [(45.8±1.6) min and (42.5±1.5) min vs.(48.0±1.4) min,P＜0.05].The bursting pressure on the third day was lower [(36.9±4.6) mm Hg and (39.8±4.1) mm Hg vs. (50.5±4.2) mm Hg,P＜0.05].There was no significant difference in bursting pressure on the 7th day among the three groups [(95.0±7.9) mm Hg and (97.8±6.8) mm Hg vs. (98.5±7.0) mm Hg,P＞0.05].HE staining revealed that metal closure had a better healing and Masson staining reflected no significant difference in healing at the same time point.Conclusions Metal clips closure full-thickness defects in the stomach,regardless in full thickness or mucosa closure,is as safe and effective as suture closure.
