Department of General Surgery, Memorial Atasehir Hospital, Istanbul, Turkey.
J Surg Res. 2013 Jun 1;182(1):142-5. doi: 10.1016/j.jss.2012.08.033. Epub 2012 Sep 11.
Intestinal anastomoses are always risky in patients who develop intra-abdominal sepsis. In this study, the effects of combined glutamine and growth hormone (GH) on healing of intestinal anastomosis following intestinal repair in the rat intra-abdominal sepsis was induced.
Forty Sprague Dawley Albino rats at 10 weeks weighing between 180 and 240 g were included in the study. All the animals were divided into five groups comprising eight rats each. In the control group, no treatment was given in addition to the routine oral nutrition before and after surgery. In the other groups, following surgery, oral glutamine was given at a dose of 1 mg/kg/d in the glutamine group, subcutaneous GH was given at a dose of 1 mg/kg/d in the GH group, and combined glutamine and GH were administered at the same doses in the glutamine + GH group. In rats, a clinical model mimicking intestinal fistula was generated and fistula repair was performed, and the bursting pressure of the repair area and tissue hydroxyproline level of the repair area were calculated.
Compared with the control group, glutamine, GH, and combined groups displayed significantly higher mean bursting pressures and tissue hydroxyproline levels.
In order to decrease the risks originating from impaired mechanisms due to intra-abdominal sepsis, and to make anastomosis safer, combined use of glutamine and GH increases the bursting pressure of anastomosis. While the use of either of these two substances alone is effective, combined use makes this effect more prominent.
对于发生腹腔内感染的患者,肠吻合术总是存在风险。本研究旨在探讨联合应用谷氨酰胺和生长激素(GH)对腹腔内感染大鼠肠吻合口愈合的影响。
将 40 只 10 周龄、体重 180-240g 的 Sprague Dawley 白化大鼠纳入研究。所有动物分为五组,每组 8 只。对照组除常规术前和术后口服营养支持外,不给予其他治疗。在其他组中,术后分别给予谷氨酰胺 1mg/kg/d(谷氨酰胺组)、GH 1mg/kg/d(GH 组)和谷氨酰胺+GH 联合治疗(谷氨酰胺+GH 组)。在大鼠中,建立模拟肠瘘的临床模型并进行瘘修补,计算修复区域的爆裂压力和组织羟脯氨酸水平。
与对照组相比,谷氨酰胺组、GH 组和联合组的平均爆裂压力和组织羟脯氨酸水平显著升高。
为了降低腹腔内感染导致的受损机制带来的风险,使吻合术更安全,联合应用谷氨酰胺和 GH 可增加吻合口的爆裂压力。虽然单独使用这两种物质中的任何一种都有效,但联合使用可使这种效果更为显著。