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纤维蛋白胶在有无腹膜炎情况下对结肠吻合口强度的影响:一项大鼠实验性随机对照试验

The effect of fibrin glue on the intensity of colonic anastomosis in the presence and absence of peritonitis: an experimental randomized controlled trial on rats.

作者信息

Senol Metin, Altintas Mehmet M, Cevık Ayhan, Altuntas Yunus E, Barisik Nagehan O, Bildik Nejdet, Oncel Mustafa

机构信息

Department of General Surgery, Nevsehir State Hospital, 50000 Nevsehir, Turkey.

出版信息

ISRN Surg. 2013;2013:521413. doi: 10.1155/2013/521413. Epub 2013 Jan 21.

Abstract

Aim. Anastomotic leakage after colon anastomosis is the most frequent and most feared complication with its highest mortality rate. In this study, we aimed to expose the impact of performing fibrin glue on sutured colocolic anastomosis, in the presence of experimental peritonitis, on anastomosis safety. Method. In this experimental study, the rats were divided into two groups as control group (Groups 1 and 3) and experimental group (Groups 2 and 4). They were also divided as clean abdomen (Groups 1 and 2) and infected abdomen (3 and 4) groups. Full-thickness incisions were made on the proximal colon of both groups of rats. The control group's anastomoses were conducted only with sutures, whereas in experimental group, fibrin glue was applied over the sutures. The samples were taken on the 10th day. Results. Highest values for average levels of hydroxyproline in the tissues and anastomotic bursting pressures were detected when fibrin glue was applied on sutured anastomosis in clean abdomen. In the histopathological staging performed in line with Ehrlich-Hunt model, lowest values were detected during the presence of peritonitis. Conclusion. As a result, it has been established that the use of fibrin glue over sutured colocolic anastomosis, both in clean abdomen and in the presence of peritonitis, had increased anastomosis safety.

摘要

目的。结肠吻合术后吻合口漏是最常见且最令人担忧的并发症,其死亡率最高。在本研究中,我们旨在揭示在实验性腹膜炎存在的情况下,对缝合的结肠结肠吻合口应用纤维蛋白胶对吻合口安全性的影响。方法。在本实验研究中,将大鼠分为对照组(第1组和第3组)和实验组(第2组和第4组)。它们又分为清洁腹部组(第1组和第2组)和感染腹部组(第3组和第4组)。两组大鼠的近端结肠均做全层切口。对照组的吻合仅用缝线进行,而实验组在缝线上应用纤维蛋白胶。在第10天取样。结果。当在清洁腹部的缝合吻合口上应用纤维蛋白胶时,检测到组织中羟脯氨酸平均水平和吻合口破裂压力的最高值。在按照埃利希 - 亨特模型进行的组织病理学分期中,在腹膜炎存在期间检测到最低值。结论。结果表明,在清洁腹部以及存在腹膜炎的情况下,在缝合的结肠结肠吻合口上使用纤维蛋白胶均提高了吻合口安全性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7528/3563166/348ee29e1115/ISRN.SURGERY2013-521413.001.jpg

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