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在肠道吻合术中使用氰基丙烯酸酯是一种良好且可靠的替代方法吗?

Is the use of cyanoacrylate in intestinal anastomosis a good and reliable alternative?

作者信息

Elemen Levent, Sarimurat Nuvit, Ayik Bekir, Aydin Seval, Uzun Hafize

机构信息

Department of Pediatric Surgery, Medical Faculty, Kocaeli University, Kocaeli, Turkey.

出版信息

J Pediatr Surg. 2009 Mar;44(3):581-6. doi: 10.1016/j.jpedsurg.2008.08.033.

Abstract

PURPOSE

The present study aims to compare strength, healing, and operation time of experimental intestinal anastomoses performed by polyglactin 910 (Vicryl; Ethicon, Edinburgh, United Kingdom) sutures with ethyl-2-cyanoacrylate glue (Pattex; Henkel, Dusseldorf, Germany).

MATERIAL AND METHODS

Ninety-six Sprague-Dawley rats were divided into 2 (groups E and L). Each group was further subdivided into 6 subgroups (EA1, EA2, EA3, EB1, EB2, EB3, LA1, LA2, LA3, LB1, LB2, LB3), each containing 8 rats. Intestinal anastomosis was performed by polyglactin 910 sutures in A subgroups and with ethyl-2-cyanoacrylate in B subgroups. The anastomosis was end to end in A1 and B1, side to side in A2 and B2, and end to side in A3 and B3. Time for anastomosis performance (AT) was recorded. In group E, bursting pressures and hydroxyproline levels were determined on the second postoperative day, whereas in group L, the same measurements were made on the sixth postoperative day. One-way analysis of variance was used for analyses of variance in the groups. Quantitative data were analyzed with Student's t test. P value was considered significant at less than .05.

RESULTS

There was no significant difference between bursting pressures of subgroup pairs on both postoperative days 2 and 6. Hydroxyproline levels and AT were significantly better in B subgroups.

CONCLUSION

Better healing, shorter AT, and equal strength were achieved with ethyl-2-cyanoacrylate compared with polyglactin 910 sutures in intestinal anastomosis in the experimental setting.

摘要

目的

本研究旨在比较使用聚乙醇酸910(爱惜康;Ethicon,英国爱丁堡)缝线与2-氰基丙烯酸乙酯胶水(百得胶;汉高,德国杜塞尔多夫)进行实验性肠吻合术的强度、愈合情况及手术时间。

材料与方法

96只Sprague-Dawley大鼠被分为2组(E组和L组)。每组再进一步细分为6个亚组(EA1、EA2、EA3、EB1、EB2、EB3、LA1、LA2、LA3、LB1、LB2、LB3),每组包含8只大鼠。A亚组使用聚乙醇酸910缝线进行肠吻合术,B亚组使用2-氰基丙烯酸乙酯进行肠吻合术。A1和B1组为端端吻合,A2和B2组为侧侧吻合,A3和B3组为端侧吻合。记录吻合操作时间(AT)。E组在术后第二天测定破裂压力和羟脯氨酸水平,而L组在术后第六天进行相同测量。采用单因素方差分析对组间差异进行分析。定量数据采用Student's t检验进行分析。P值小于0.05被认为具有统计学意义。

结果

术后第2天和第6天,各亚组对之间的破裂压力无显著差异。B亚组的羟脯氨酸水平和AT明显更好。

结论

在实验环境下的肠吻合术中,与聚乙醇酸910缝线相比,2-氰基丙烯酸乙酯实现了更好的愈合、更短的AT且强度相当。

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