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氨磷汀(依替膦酸)对放射性肠炎大鼠肠吻合口的影响。

The effect of Amifostine (Ethyol) on intestinal anastomosis in rats with radiation enteritis.

机构信息

General Surgery Department, Elazig Teaching and Research Hospital, Elazig, Turkey.

出版信息

Eur Rev Med Pharmacol Sci. 2013 May;17(10):1351-9.

Abstract

BACKGROUND

Preoperative radiotherapy in colorectal cancers is being used as an adjuvant therapy with increasing frequency. Postoperative complications in early and late periods in various ratios are reported. It has also been shown that radiation has a delaying effect on wound healing and this effect is dose-dependent.

AIM

This study investigated the effects of the Amifostine on healing of the irradiated colonic anastomosis.

MATERIALS AND METHODS

30 female Wistar rats were divided randomly into three groups equally (n=10). Colonic anastomosis were performed to all rats. Group I served as a control. 800 rad abdominopelvic irradiation on the 5th day of preoperation was given to group II and III. Rats in the group III, prior to radiation, were given Amifostine at a dose of 200 mg/kg. On the 5th postoperative day all the rats were sacrificed and the healing of anastomosis was measured with bursting pressure, hydroxyproline levels and histopathological evaluations. Statistical analyses were expressed by analysis of variance (ANOVA) test and p < 0.05 was regarded as significant.

RESULTS

In group II, all parameters were found lower compared with control group and Amifostine+Radiation group. As compared with hydroxyproline values and the anastomotic wound healing scores, except group II, no significantly difference were determined between the two other groups. In bursting pressure levels, Group I and III were higher than group II, but not statistically significant (p > 0.05). In group III (Amifostine+Radiation group), the hydroxyproline levels and anastomotic wound healing scores were found significantly higher than group II (p < 0.05), and no significant difference were found between the control group.

CONCLUSIONS

It is determined that radiation given on the 5th preoperative day has a negative effect on anastomotic wound healing and administered Amifostine prevent this negative effect. In the light of these data, the Amifostine may have a positive effect on preoperative irradiated colonic anastomosis and may play an important role in future on the supporting of the colonic anastomosis.

摘要

背景

术前放疗在结直肠癌中作为辅助治疗的应用频率越来越高。报告了各种比例的早期和晚期术后并发症。已经表明,辐射对伤口愈合有延迟作用,这种作用是剂量依赖性的。

目的

本研究探讨了氨磷汀对放射性结直肠吻合口愈合的影响。

材料和方法

将 30 只雌性 Wistar 大鼠随机均分为三组(n=10)。所有大鼠均行结肠吻合术。第 I 组为对照组。第 2 组和第 3 组在术前第 5 天接受 800rad 腹部盆腔照射。第 3 组大鼠在放疗前给予氨磷汀 200mg/kg。术后第 5 天,所有大鼠均处死,通过爆裂压、羟脯氨酸水平和组织病理学评价测量吻合口愈合情况。统计分析采用方差分析(ANOVA)检验,p<0.05 为差异有统计学意义。

结果

第 2 组的所有参数均低于对照组和氨磷汀+放疗组。与羟脯氨酸值和吻合口愈合评分相比,除第 2 组外,其余两组之间无显著差异。在爆裂压水平上,第 1 组和第 3 组高于第 2 组,但无统计学意义(p>0.05)。第 3 组(氨磷汀+放疗组)的羟脯氨酸水平和吻合口愈合评分明显高于第 2 组(p<0.05),与对照组无显著差异。

结论

术前第 5 天给予的放疗对吻合口愈合有负面影响,给予氨磷汀可预防这种负面影响。鉴于这些数据,氨磷汀可能对术前放射性结直肠吻合口有积极作用,并可能在未来对结直肠吻合口的支持中发挥重要作用。

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