Hartmann M, Jönsson K, Zederfeldt B
Department of Anaesthesiology, Malmö General Hospital, University of Lund, Sweden.
Eur J Surg. 1992 Feb;158(2):79-82.
To find out if preoperative and postoperative dehydration adversely affect anastomotic and subcutaneous healing.
Randomized study.
18 Wistar rats.
Dehydration established in nine rats by withdrawal of food and water for 24 hours before operation, and by injections of frusemide twice daily. Laparotomy and division of intestine 5-8 cm from the ileocaecal valve. Implantation of expanded polytetrafluoroethylene (ePTFE) tubes in the backs of the necks. All rats killed after five days.
Measurements of weight loss and of hydroxyproline per centimetre in the ePTFE tubes and standardized biopsy specimens of the intestine. Presence of anastomotic dehiscence at necropsy.
Preoperative and postoperative dehydration caused a 24% weight loss in the experimental group on day 5 compared with 8% in the control group. Dehydrated animals accumulated less collagen in the ePTFE tubes than control animals (p less than 0.05). There were three anastomotic breakdowns in the dehydrated group compared with one in the control group. There was a loose but significant correlation between collagen accumulation in the anastomoses and the weight of the animal (r = 0.5, p less than 0.05).
Preoperative and postoperative dehydration has a deleterious effect on subcutaneous, and to a lesser extent on anastomotic healing in rats.
探究术前及术后脱水是否会对吻合口愈合及皮下愈合产生不利影响。
随机研究。
18只Wistar大鼠。
对9只大鼠进行脱水处理，术前禁食禁水24小时，并每日注射速尿两次。进行剖腹手术，在距回盲瓣5 - 8厘米处切断肠管。在大鼠颈部后方植入膨体聚四氟乙烯（ePTFE）管。所有大鼠在五天后处死。
测量体重减轻情况、ePTFE管中每厘米羟脯氨酸含量以及标准化的肠活检标本。尸检时观察吻合口裂开情况。
与对照组第5天体重减轻8%相比，实验组术前及术后脱水导致体重减轻24%。脱水动物在ePTFE管中积累的胶原蛋白比对照动物少（p < 0.05）。脱水组有3例吻合口破裂，而对照组有1例。吻合口中胶原蛋白积累与动物体重之间存在松散但显著的相关性（r = 0.5，p < 0.05）。
术前及术后脱水对大鼠皮下愈合有有害影响，对吻合口愈合的影响较小。
