Dibbern Christian Bakholdt, Rose Morten, Ellebæk Mark Bremholm, Qvist Niels
Department of Surgery, Odense University Hospital, Odense, Denmark.
Eur J Pediatr Surg. 2017 Feb;27(1):56-60. doi: 10.1055/s-0036-1593386. Epub 2016 Oct 3.
One in 4,000 infants is born with oesophageal atresia. Approximately 15% of these have a long gap oesophageal atresia, where primary anastomosis is difficult or impossible. Previous studies have shown an effect of intramural botulinum toxin type A (BTX-A) injections on the elongation and max load of the esophagus 1 hour after injection. We hypothesized that a longer waiting period of 2 hours could increase this effect. Forty-five piglets were randomized into three groups. Two treatment groups received 2 units/kg of BTX-A and one group received saline. After 1 or 2 hours, a segment of the esophagus was harvested and put in a stretch-tension device to assess elongation and max load. Elongation from preload to max load and percentage elongation in the BTX-A 2h group (17.09 mm, 46.46%) was significantly higher compared with the BTX-A 1h group (13.59 mm, 40.16%) and the placebo group (13.77 mm, 39.92%). Elongation of the piglet esophagus was significantly improved with a 2-hour waiting period after BTX-A injection. Injections with BTX-A could be useful in oesophageal atresia, where primary anastomosis is not possible.
每4000名婴儿中就有1名患有食管闭锁。其中约15%的患者患有长段食管闭锁，这种情况下进行一期吻合术很困难或无法进行。先前的研究表明，注射壁内A型肉毒杆菌毒素（BTX-A）对注射后1小时食管的伸长和最大负荷有影响。我们推测，延长至2小时的等待期可能会增强这种效果。45只仔猪被随机分为三组。两个治疗组接受2单位/千克的BTX-A，一组接受生理盐水。1小时或2小时后，采集一段食管并放入拉伸张力装置中，以评估伸长和最大负荷。与BTX-A 1小时组（13.59毫米，40.16%）和安慰剂组（13.77毫米，39.92%）相比，BTX-A 2小时组从预负荷到最大负荷的伸长以及伸长百分比（17.09毫米，46.46%）显著更高。注射BTX-A后等待2小时可显著改善仔猪食管的伸长。对于无法进行一期吻合术的食管闭锁患者，注射BTX-A可能会有帮助。
