摘要
目的 观察Ⅰ期手术经肛吻合口上、下置管肠腔内双管引流治疗合并海水浸泡犬结肠火器伤的效果。 方法 成年健康杂种犬 16只 ,采用手枪射击致其开放性乙状结肠伤 ,经海水浸泡 1h完成模型制作。将模型分为对照组和处理组 ,每组 8只。对照组清创切除Ⅰ期吻合乙状结肠 ,处理组清创切除Ⅰ期吻合乙状结肠时 ,经肛吻合口上、下置管肠腔内双管引流。术后第 3,7天观察吻合口及其周围炎症反应、吻合口两端肠腔内滞留物、肠腔压力和血清内毒素 (ET)、肿瘤坏死因子 (TNF)的变化。 结果 处理组肠腔内容物无明显淤积 ,吻合口上、下肠腔内压力和血清ET、TNF水平均明显低于对照组 (P <0 .0 5 ) ,肠壁水肿消退快 ,吻合口炎症反应轻 ,吻合口漏的发生率明显降低。 结论 Ⅰ期手术经肛吻合口上、下双管引流法能有效地治疗合并海水浸泡的结肠火器伤 。
Objective To investigate the effect of primary resection and anastomosis with drainage by perianastomotic proximal and distal tubes through anus on the treatment of colon firearm wound and seawater immersion. Methods After the sigmoid colon was injured by pistol shot, dogs were soaked in seawater for 1 hour, and were divided in control and treatment groups. There were 8 dogs in each group. In control group, primary resection and anastomosis of the sigmoid colon were performed. In treatment group, after the resection and anastomosis of the colon, two drainage tubes were placed in the colon cavity via proximal and distal anastomotic stoma to the anus. Anastomotic stoma and perianastomotic stoma inflammation, the pressure of the colon cavity, serum endotoxin (ET), tumor necrosis factor (TNF) level were detected on 3rd and 7th day after operation. Results There were less fecal accumulation and inflammation in anastomotic stoma and perianastomotic stoma, lower pressure in colon cavity, lower level of ET and TNF in serum in treatment group than those in control group(P<0.05). In treatment group, edema of the colon wall recovered more rapidly, and anastomotic stoma leakage was obviously reduced. Conclusions Primary resection and anastomosis with drainage by perianastomotic proximal and distal tubes through anus can effectively treat colon firearm wounds with seawater immersion, and reduce anastomotic leakage after operation.
出处
《中华创伤杂志》
CAS
CSCD
北大核心
2001年第10期598-600,共3页
Chinese Journal of Trauma
基金
广东省医学基金资助项目 (A2 0 0 0 5 41)
