Jonsson T, Högström H
Department of Surgery, Lund University, Malmö General Hospital, Sweden.
Eur Surg Res. 1991;23(3-4):235-9. doi: 10.1159/000129158.
We compared the suture holding capacity of rat intestinal anastomoses after division of the bowel with scissors or diathermy. Two sets of experiments differing in suture technique were done. In one set the amount and solubility of anastomotic collagen were measured, and neutrophil accumulation quantified with a myeloperoxidase (MPO) assay. MPO activity 24 h after surgery was 60% higher (p less than 0.05) after division with diathermy than after division with scissors. Suture holding capacity (breaking strength) decreased by approximately 70% (p less than 0.001) in both groups when sutures were inserted near the bowel edges, while no decrease was noted when sutures were inserted at a farther distance, regardless of the mode of bowel division. After 7 days MPO levels approached baseline values in both groups and the bowel always ruptured outside the anastomosis. Collagen content was not adversely affected by diathermy. Although the reduction in early anastomotic strength may be mediated by local neutrophil activity, suture holding capacity was not influenced by the increased neutrophil accumulation elicited by diathermy.
我们比较了用剪刀或透热法切断肠管后大鼠肠吻合口的缝线持力。进行了两组缝线技术不同的实验。在一组实验中，测量吻合口胶原蛋白的含量和溶解性，并用髓过氧化物酶（MPO）测定法对中性粒细胞聚集进行定量。术后24小时，透热法切断组的MPO活性比剪刀切断组高60%（p<0.05）。当在肠边缘附近插入缝线时，两组的缝线持力（断裂强度）均下降约70%（p<0.001），而当在较远位置插入缝线时，无论肠管切断方式如何，均未观察到下降。7天后，两组的MPO水平均接近基线值，且肠管总是在吻合口外破裂。透热法对胶原蛋白含量没有不利影响。虽然早期吻合口强度的降低可能由局部中性粒细胞活性介导，但缝线持力不受透热法引起的中性粒细胞聚集增加的影响。
