【摘要】 目的探讨胃肠道浆肌层吻合的可行性。方法中国家兔分成4组,A组(浆肌层吻合)、B组(二层吻合)、C组(一层吻合)和D组(黏膜外吻合),每组10只。每只动物行胃十二指肠侧侧吻合、回肠端端吻合(2个)和结肠端端吻合(2个)。术后测定吻合破裂压、组织羟脯氨酸含量和组织病理学检查。结果(1)术后第3天,A组胃肠道吻合的吻合破裂压、羟脯氨酸含量与B、C、D组差异无统计学意义；(2)第7天,A组吻合破裂压在胃十二指肠吻合中高于B、C组(P＜0．05),回肠吻合中高于B组(P＜0．01),结肠吻合中高于B、C、D组(P＜0．05)；胃十二指肠吻合组织羟脯氨酸含量A组高于B组(P＜0．05),和C、D组差异无统计学意义；(3)A组的炎症反应在胃十二指肠吻合中与B、C、D组相似,回肠吻合中最轻,结肠吻合中与B组相似。结论胃肠道浆肌层吻合是一种安全、可靠,简便的吻合方法。更多还原

【Abstract】 Objective To explore the feasibility of seromuscular layer anastomosis of gastrointesti- nal tract in rabbits.Methods Chinese rabbits were divided into 4 groups:group A （seromuscular layer anastomosis,n=10）,group B （double-layer inverted anastomosis,n=10）,group C （single-layer inverted anastomosis,n=10） and group D （extramucosal anastomosis,n=10）.Five anastomoses were performed on each animal,one in aide-to-aide gastroduodenal anastomosis,two in end-to-end ileal and colonic anasto- moses respectively.Half of each group was sacrificed on the postoperative day 3 and 7 to determine in situ anastomotic bursting pressures,hydroxyproline contents and histopathological evaluation of the anasto- mode sites.Results （1） On the day 3,anastomotic bursting pressure and hydroxyproline content in group A were not significantly different from groups B,C and D;（2） On the day 7,bursting pressure showed no significant difference among groups B,C and D for gastroduodenal,ileal and colonic anasto- moses,but dramatically higher in group A than in groups.B and C [（200.4±19.4） vs （144.0±30.8）, （144.8±42.4） cm H₂O,P＜0.05,respectively] in gastroduodenal anastomosis,and group B [（217.6±30.8） vs （149.4±14.7） cm H₂O,P＜0.01] in ileal anastomosis,and also groups B,C and D [（306.2±47.5） vs （234.0±33.7）,（250.0±50.1）,（247.6±32,1） cm H₂O,P＜0.05,respectively] in colonic anastomosis.Hydroxyproline content was higher in group A than in group B in gastroduodenal anastomosis on the day 7 （1 015.7±99.6） vs （616.5±87.9）μg/g tissue wet weight,P＜0.05];（3） Histological examination of the anastomoses showed that the inflammatory reaction of the gastrointestinal wall had no differences among the 4 groups in gastroduodenal anastomosis,but decreased in group A in ileal anastomosis as compared with groups B,C and D on the day 3 and 7.For colonic anastomosis,the profound inflammatory reaction was similar in groups A and B on the day 7.Conclusion Seromuscular layer anastomosis of gastrointestinal tract is as safe as other hand-sewn anastomosis,and more convenient and simpler.更多还原