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大鼠肝切除术后电灼术与纤维蛋白封闭剂的比较。

Comparison between electrocautery and fibrin selant after hepatectomy in rats.

作者信息

Coutinho Tâmara Rúbia Cavalcante Guimarães, Malafaia Osvaldo, Torres Orlando Jorge Martins, Ribas Filho Jurandir Marcondes, Kaminski Alvaro Fonseca, Cella Igor Furlan, Jurkonis Leandro Bressianini

机构信息

Hospital Universitário de Curitiba, Instituto de Pesquisas Médicas, Paraná, PR, Brazil.

Hospital São Domingos, São Luis, Maranhão, Brazil.

出版信息

Rev Col Bras Cir. 2014 May-Jun;41(3):198-202. doi: 10.1590/s0100-69912014000300011.

Abstract

OBJECTIVE

To compare between electrocautery and fibrin sealant hemostasis in rats after partial hepatectomy.

METHODS

we used 24 Wistar rats, which were submitted to 30% hepatic resection, divided into two groups of 12 animals each: Group Electrocautery and Group Tachosil(r). These animals were evaluated after three and 14 days. We assessed the presence of complications, laboratory tests and histological exam of the recovered liver.

RESULTS

the presence of abscess was more prevalent in the electrocautery group. The observed adhesions were more pronounced in the electrocautery group, both in frequency and in intensity, after three and 14 days. There were no deaths in either group. As for laboratory analysis, after three days the hematocrit was lower in the TachoSil(r) Group. The elevation of AST and ALT were more pronounced in the electrocautery group (p = 0.002 and p = 0.004) in three days. Histological analysis of specimens collected on the third day after surgery showed similar results in both groups for the presence of polymorphonuclear cells, whereas mononuclear was more evident in the TachoSil(r) group. We also observed that angiogenesis, although present in both groups, was more pronounced in the TachoSil(r) group (p = 0.030). However, on the 14th day angiogenesis was more pronounced in the electrocautery group, but without statistical significance.

CONCLUSION

hemostasis achieved by the groups was similar; however, the use of electrocautery was associated with infections, adhesions at higher grades and elevated liver enzymes.

摘要

目的

比较大鼠部分肝切除术后电灼止血法与纤维蛋白封闭剂止血法的效果。

方法

我们选用24只Wistar大鼠,对其进行30%的肝切除术,将其分为两组,每组12只动物:电灼组和速即纱组。在术后3天和14天对这些动物进行评估。我们评估了并发症的发生情况、实验室检查以及再生肝脏的组织学检查。

结果

电灼组脓肿的发生率更高。在术后3天和14天,电灼组观察到的粘连在频率和强度上都更为明显。两组均无死亡病例。至于实验室分析,术后3天速即纱组的血细胞比容较低。术后3天,电灼组的谷草转氨酶(AST)和谷丙转氨酶(ALT)升高更为明显(p = 0.002和p = 0.004)。术后第三天采集的标本组织学分析显示,两组中性粒细胞的存在情况相似,而单核细胞在速即纱组更为明显。我们还观察到,血管生成虽然在两组中都存在,但在速即纱组更为明显(p = 0.030)。然而,在第14天,电灼组的血管生成更为明显,但无统计学意义。

结论

两组实现的止血效果相似;然而,电灼的使用与感染、更高程度的粘连以及肝酶升高有关。

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