Kaya Cemal, Demir Uygar, Coşkun Halil, Kalyoncu Ali, Gündüz Burhan, Eroğlu Tülay, Ağca Birol, Mihmanli Mehmet
Department of General Surgery, Sişli Etfal Research and Training Hospital, Istanbul, Turkey.
Ulus Travma Acil Cerrahi Derg. 2004 Jan;10(1):11-6.
We compared three repair techniques, namely, simple closure and omentoplasty, simple closure alone, and fibrin tissue adhesive, in the treatment of rat duodenal perforations induced in the postpyloric region.
Thirty male Sprague-Dawley rats (210-240 g) were included. Under ketamine and ether anesthesia, duodenal perforations of 2 mm were induced in all rats in the postpyloric region. The rats were assigned to three groups equal in number, which underwent repair with the use of simple closure and omentoplasty, simple closure alone, and fibrin glue, respectively. All the animals were sacrificed under deep ether anesthesia on the fourth postoperative day. To assess wound strength, bursting pressure measurements were performed. In addition, hydroxyproline content of the wound site was measured by absorbance spectrophotometry at 560 nm.
The mean bursting pressure in the simple closure and omentoplasty group was significantly higher than those of the simple closure (p<0.05) and fibrin glue (p<0.001) groups. No significant difference existed between the simple closure and fibrin glue groups in this respect (p>0.05). Hydroxyproline values of the simple closure and omentoplasty (p<0.05) and simple closure (p<0.001) groups were significantly lower than that of the fibrin glue group.
Fibrin tissue adhesives may have an application in the treatment of duodenal ulcer perforations, as an adjunct to laparoscopic or open surgical methods.
我们比较了三种修复技术，即单纯缝合与网膜成形术、单纯缝合以及纤维蛋白组织粘合剂，用于治疗幽门后区域诱导的大鼠十二指肠穿孔。
纳入30只雄性Sprague-Dawley大鼠（体重210 - 240克）。在氯胺酮和乙醚麻醉下，在所有大鼠的幽门后区域制造2毫米的十二指肠穿孔。将大鼠平均分为三组，分别采用单纯缝合与网膜成形术、单纯缝合以及纤维蛋白胶进行修复。所有动物在术后第四天在深度乙醚麻醉下处死。为评估伤口强度，进行爆破压力测量。此外，通过在560纳米处的吸光度分光光度法测量伤口部位的羟脯氨酸含量。
单纯缝合与网膜成形术组的平均爆破压力显著高于单纯缝合组（p<0.05）和纤维蛋白胶组（p<0.001）。在这方面，单纯缝合组与纤维蛋白胶组之间无显著差异（p>0.05）。单纯缝合与网膜成形术组（p<0.05）和单纯缝合组（p<0.001）的羟脯氨酸值显著低于纤维蛋白胶组。
纤维蛋白组织粘合剂作为腹腔镜或开放手术方法的辅助手段，可能在十二指肠溃疡穿孔的治疗中具有应用价值。
