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甲状腺激素治疗对袖状胃切除术后残余胃切面愈合及短期体重变化的影响。

Effects of Thyroid Hormone Therapy on Cut-Surface Healing of the Remnant Stomach with Short-Term Weight Loss Alterations after Sleeve Gastrectomy.

作者信息

Orman Suleyman, Karaman Kerem, Basok Banu Isbilen, Kisa Ucler, Ceyran Ayse Bahar, Bostanci Erdal Birol

机构信息

a Department of Gastroenterological Surgery , Istanbul Medeniyet University Goztepe Teaching and Research Hospital , Istanbul , Turkey.

b Department of General Surgery , Sakarya University Faculty of Medicine , Sakarya , Turkey.

出版信息

J Invest Surg. 2018 Apr;31(2):153-162. doi: 10.1080/08941939.2017.1280566. Epub 2017 Feb 16.

Abstract

BACKGROUND

The hypothalamic-pituitary-tyhroid axis is directly affected by drastic changes in energy stores. The aim of the present study was to determine the effects of triiodothyronine (T3) treatment on cut-surface healing of remnant stomach with weight loss alterations after sleeve gastrectomy (SG).

METHODS

Thirty male Wistar Albino rats were divided into three groups: sham (n = 6), control (n = 12), and experimental (n = 12). Control and experimental group rats underwent sleeve gastrectomy. Experimental group rats received a single dose of T3 (400 mg/100 g) on the first postoperative day whereas control group rats received 0.9% NaCl. All rats were sacrificed on the seventh postoperative day.

RESULTS

In the group of rats receiving T3, levels of FT3 were significantly higher and that of FT4 were significantly lower compared with both the control and sham group rats (p <.05). No significant difference was found between control and T3 group rats in terms of weight loss (p >.05). Microscopic examination of the cut surface of remnant stomach in the control group rats revealed significantly more severe tissue necrosis, edema, and disruption of mucosal epithelium than in the T3 group rats (p <.05). On the other hand, bridging of the submucosal and muscular layers, tissue granulation, fibroblast accumulation, neoangiogenesis, and collagen deposition in the T3 group rats were significantly higher than in the control group rats (p <.05).

CONCLUSIONS

Sleeve gastrectomy did not significantly alter thyroid hormone levels in short term. T3 hormone therapy seems to deliver constructive therapeutic effects for wound healing while causing no adverse effect on weight reduction.

摘要

背景

下丘脑 - 垂体 - 甲状腺轴直接受能量储备剧烈变化的影响。本研究的目的是确定三碘甲状腺原氨酸(T3)治疗对袖状胃切除术后(SG)体重减轻改变的残胃切面愈合的影响。

方法

30只雄性Wistar白化大鼠分为三组:假手术组(n = 6)、对照组(n = 12)和实验组(n = 12)。对照组和实验组大鼠接受袖状胃切除术。实验组大鼠在术后第一天接受单剂量T3(400μg/100g),而对照组大鼠接受0.9%氯化钠。所有大鼠在术后第七天处死。

结果

与对照组和假手术组大鼠相比,接受T3的大鼠组中FT3水平显著升高,FT4水平显著降低(p <.05)。对照组和T3组大鼠在体重减轻方面未发现显著差异(p >.05)。对照组大鼠残胃切面的显微镜检查显示,与T3组大鼠相比,组织坏死、水肿和黏膜上皮破坏明显更严重(p <.05)。另一方面,T3组大鼠黏膜下层和肌层的桥接、组织肉芽形成、成纤维细胞聚集、新生血管形成和胶原沉积显著高于对照组大鼠(p <.05)。

结论

袖状胃切除术短期内未显著改变甲状腺激素水平。T3激素治疗似乎对伤口愈合具有建设性治疗作用,同时对体重减轻无不良影响。

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