低分子量肝素会损害吻合口伤口愈合吗？

Does low molecular weight heparin impair anastomotic wound healing?

作者信息

Ergul Emre, Ozgun Yigit Mehmet, Kiyak Gulten, Barit Ozgun Gonca, Korukluoglu Birol, Kusdemir Ahmet

机构信息

General Surgery Department, Ankara Ataturk Teaching and Research Hospital, Askaabat Cad. Eser Sitesi B Blok 3.Giris, Daire:11 Bahcelievler, 06490, Ankara, Turkey.

出版信息

J Gastrointest Surg. 2009 Apr;13(4):798-803. doi: 10.1007/s11605-008-0771-9. Epub 2008 Dec 13.

DOI:10.1007/s11605-008-0771-9

PMID:19083069

Abstract

BACKGROUND

Enoxaparin is an important molecule which had been using in prophylaxis and treatment of deep venous thrombosis. Also, it is showed that it prevents postsurgical peritoneal adhesions in rats. It is aimed to evaluate its effects on gastrointestinal wound healing.

METHODS

Thirty Wistar albino rats were divided into three groups as control, subcutan, and intraperitoneal enoxaparin groups. Left colon anastomoses were performed. On postoperative seventh day, anastomotic healing was evaluated by measuring anastomotic bursting pressure, tissue hydroxyproline levels, and histopathological examination.

RESULTS

The anastomotic bursting pressure was highest in subcutan enoxaparin group (p < 0.001), intraperitoneal enoxaparin group (p < 0.01) came the second, and the control group has the worst value. The hydroxyproline results were found nearly similar to the bursting pressure values (subcutan (p < 0.001) > intraperitoneal (p < 0.05) > control). Neovascularization in subcutan group (p < 0.001) has a statistically significant difference to other groups.

CONCLUSION

Enoxaparin did not interfere with colonic anastomotic resistance but improved the intestinal wound healing.

摘要

背景

依诺肝素是一种重要的分子，已用于预防和治疗深静脉血栓形成。此外，研究表明它可预防大鼠术后腹膜粘连。本研究旨在评估其对胃肠道伤口愈合的影响。

方法

将30只Wistar白化大鼠分为三组，即对照组、皮下注射依诺肝素组和腹腔注射依诺肝素组。进行左结肠吻合术。术后第7天，通过测量吻合口破裂压力、组织羟脯氨酸水平和组织病理学检查来评估吻合口愈合情况。

结果

皮下注射依诺肝素组的吻合口破裂压力最高（p < 0.001），腹腔注射依诺肝素组次之（p < 0.01），对照组最差。羟脯氨酸结果与破裂压力值相近（皮下注射组（p < 0.001）>腹腔注射组（p < 0.05）>对照组）。皮下注射组的新生血管形成（p < 0.001）与其他组相比有统计学显著差异。