Kanmaz T, Yağmurlu A, Aktuğ T, Gökçora H
Department of Pediatric Surgery, Ankara University Faculty of Medicine, Ankara, Turkey.
J Pediatr Surg. 2001 Sep;36(9):1341-5. doi: 10.1053/jpsu.2001.26364.
BACKGROUND/PURPOSE: Prolonged exposure to amniotic fluid causes the intestinal changes such as serosal edema, thickening, fibrous coating, and adhesions in gastroschisis. The effect of amnio-allantoic fluid (AAF) pH on intestines was evaluated using a chick embryo gastroschisis model.
Seventy fertile eggs were divided into 5 groups: preliminary study (PS, n = 20), AAF control (AAC, n = 10), just gastroschisis (JG, n = 10), gastroschisis pretreated with placebo (GPP, n = 15), and gastroschisis pretreated with sodium bicarbonate (GPS, n = 15). The PS group was also divided into 2 subgroups to determine the biochemical differences between the amniotic and the allantoic fluid. Gastroschisis was created surgically at the 14th day of incubation. In GPS group, 8.4% NaHCO(3) solution (0.1 mL/100 mg/d) was instilled into the AAF for 4 days.
A significant decrease in intestinal damage was observed both macroscopically and microscopically in the group GPS compared with the JG and GPP groups.
Pretreatment with alkalization of AAF prevented intestinal damage because of gastroschisis. Alkalization could be a simple alternative for pretreatment with amniotic fluid exchange for human fetuses with gastroschisis.
背景/目的：在腹裂患儿中，长时间暴露于羊水会导致肠道出现诸如浆膜水肿、增厚、纤维包裹及粘连等变化。本研究使用鸡胚腹裂模型评估羊膜 - 尿囊液（AAF）pH值对肠道的影响。
将70枚受精蛋分为5组：初步研究组（PS，n = 20）、AAF对照组（AAC，n = 10）、单纯腹裂组（JG，n = 10）、用安慰剂预处理的腹裂组（GPP，n = 15）以及用碳酸氢钠预处理的腹裂组（GPS，n = 15）。PS组又分为2个亚组以确定羊水和尿囊液之间的生化差异。在孵化第14天通过手术制造腹裂模型。在GPS组中，将8.4%的NaHCO₃溶液（0.1 mL/100 mg/d）注入AAF中，持续4天。
与JG组和GPP组相比，GPS组在宏观和微观上均观察到肠道损伤显著减轻。
AAF碱化预处理可预防腹裂所致的肠道损伤。碱化可能是一种简单的替代方法，可用于对患有腹裂的人类胎儿进行羊水交换预处理。
