Şen Tanrıkulu Ceren, Tanrıkulu Yusuf, Kılınç Fahriye, Bahadır Burak, Can Murat, Köktürk Fürüzan, Kefeli Ayşe
Department of Emergency Medicine, Health Sciences University, Konya Training and Research Hospital, Konya-Turkey.
Department of General Surgery, KTO Karatay University Faculty of Medicine, Konya-Turkey.
Ulus Travma Acil Cerrahi Derg. 2019 Jul;25(4):317-323. doi: 10.5505/tjtes.2018.58506.
In developing countries, esophageal burns are quite common. They are caused by the ingestion of corrosive substances that may lead to esophageal perforation in the short-term and stricture formation in the long-term. Prevention of stricture progression in the esophagus is the main aim of the treatment for corrosive esophageal burns. We aimed to investigate the protective and anti-inflammatory effects of methylene blue (MB) treatment on corrosive esophageal burns.
Twenty-eight rats were used in the study and randomly divided into four equal groups; group 1 (Sham), group 2 (control), group 3 (topical treatment), and group 4 (topical plus systemic treatment). Except for group 1 (Sham group), all three groups received sodium hydroxide (NaOH) in order to generate esophageal burns. In addition, group 2 was given normal saline, group 3 topical MB, and group 4 topical and systemic MB.
Hydroxyproline levels were found to be lower in each of the treatment groups as compared to the control group (p=0.005 for group 3 and p=0.009 for group 4). There were no differences in the tumor necrosis factor-α (TNF-α) levels between the groups. The stenosis index (SI) in the treatment groups was also lower than the control group (p=0.016 for group 3 and p=0.015 group 4). The histopathologic damage score (HDS) was prominently lower in group 4 as compared to the control group (p=0.05).
MB is effective in treating tissue damage caused by corrosive esophageal burns and in preventing esophageal stenosis. Complication rates of corrosive esophageal burns may be decreased by using MB in the initial treatment stage.
在发展中国家，食管烧伤颇为常见。它们是由摄入腐蚀性物质所致，这些物质短期内可能导致食管穿孔，长期则会引发狭窄形成。预防食管狭窄进展是腐蚀性食管烧伤治疗的主要目标。我们旨在研究亚甲蓝（MB）治疗对腐蚀性食管烧伤的保护和抗炎作用。
本研究使用了28只大鼠，随机分为四组，每组数量相等；第1组（假手术组）、第2组（对照组）、第3组（局部治疗组）和第4组（局部加全身治疗组）。除第1组（假手术组）外，其余三组均给予氢氧化钠（NaOH）以造成食管烧伤。此外，第2组给予生理盐水，第3组给予局部MB，第4组给予局部和全身MB。
与对照组相比，各治疗组的羟脯氨酸水平均较低（第3组p = 0.005，第4组p = 0.009）。各组之间肿瘤坏死因子-α（TNF-α）水平无差异。治疗组的狭窄指数（SI）也低于对照组（第3组p = 0.016，第4组p = 0.015）。与对照组相比，第4组的组织病理学损伤评分（HDS）显著更低（p = 0.05）。
MB在治疗腐蚀性食管烧伤引起的组织损伤和预防食管狭窄方面有效。在初始治疗阶段使用MB可降低腐蚀性食管烧伤的并发症发生率。
