CAJ | 학술논문

目的探讨门脉高压症巨脾大部切除后残脾组织内胶原、弹力及网状纤维的变化,为巨脾保脾术寻找理论依据.方法选取门静脉高压症脾肿大患者13例,采用手术和穿刺活检获取脾组织标本,分为巨脾组和残脾组.另设外伤性脾破裂标本13例为对照组.应用Masson染色、EVG染色及改良氨银染色,光镜下进行比较分析.结果胶原纤维、弹力纤维、网状纤维含量,残脾组分别为(7.81±0.83)％、(7.72±3.42)％、(4.67±1.09)％；巨脾组分别为(7.76±0.81)％、(7.21±3.18)％、(4.79±1.20)％；对照组分别为(3.21±0.51)％、(1.67±3.22)％、(10.92±0.86)％.残脾组胶原、弹力、网状纤维含量与巨脾组比较差异无统计学意义(P＞0.05).残脾组与巨脾组胶原和弹力纤维含量比对照组增多,差异有统计学意义(P＜0.05)；残脾组和巨脾组网状纤维含量比对照组减少,差异有统计学意义(P＜0.05).结论巨脾大部切除残脾固定腹膜后,不会加重脾组织的纤维化程度.
목적 탐토문맥고압증거비대부절제후잔비조직내효원、탄력급망상섬유적변화,위거비보비술심조이론의거.방법 선취문정맥고압증비종대환자13례,채용수술화천자활검획취비조직표본,분위거비조화잔비조.령설외상성비파렬표본13례위대조조.응용Masson염색、EVG염색급개량안은염색,광경하진행비교분석.결과 효원섬유、탄력섬유、망상섬유함량,잔비조분별위(7.81±0.83)％、(7.72±3.42)％、(4.67±1.09)％；거비조분별위(7.76±0.81)％、(7.21±3.18)％、(4.79±1.20)％；대조조분별위(3.21±0.51)％、(1.67±3.22)％、(10.92±0.86)％.잔비조효원、탄력、망상섬유함량여거비조비교차이무통계학의의(P＞0.05).잔비조여거비조효원화탄력섬유함량비대조조증다,차이유통계학의의(P＜0.05)；잔비조화거비조망상섬유함량비대조조감소,차이유통계학의의(P＜0.05).결론 거비대부절제잔비고정복막후,불회가중비조직적섬유화정도.
Objective To investigate the changes in collagen,elastic and reticular fibers in the splenic remnant after subtotal splenectomy for splenomegaly,and to study for the basis for spleenpreservation technique for this condition.Methods We studied 13 patients with splenomegaly due to portal hypertension.The specimens were obtained by operation and puncturing biopsy,and they were divided into the splenomegaly group and the splenic remnant group.The control group consisted of 13 patients with traumatic splenic rupture.Using Masson staining,EVG staining,and Silver staining,the samples were analyzed using light microscopy after staining.Results The relative contents of collagen fibers (RCC),elastic fibers (RCE),and reticular fibers (RCR) in the splenic remnant,the splenomegaly,and the normal spleen were (7.81 ±0.83)％,(7.72± 3.42)％,(4.67 ± 1.09)％;(7.76±0.81)％,(7.21±3.18)％,(4.79±1.20) ％ ; (3.21±0.51)％,(1.67±3.22)％,(10.92±0.86)％,respectively.There was no difference between the splenomegaly and the splenic remnant for the three kinds of fiber content (P＞0.05).Significantly higher numbers of collagen and elastic fibers were observed in the control group when compared with the splenic remnant and the splenomegaly groups (P＜0.05).Significantly lower numbers'of reticular fibers were observed in the splenic remnant and the splenomegaly groups when compared with the control group (P＜ 0.05).Conclusions As the remnant spleens were fixed in retropertoneum after subtotal splenectomy,there could not be excessive fibrosis in the splenic tissues.