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富氢生理盐水溶液对肠缺血再灌注损伤后进行的肠吻合术的影响。

The effects of hydrogen-rich saline solution on intestinal anastomosis performed after intestinal ischemia reperfusion injury.

机构信息

Department of Pediatric Surgery, Gazi University Faculty of Medicine, Ankara, Turkey.

Department of Pediatric Surgery, Gazi University Faculty of Medicine, Ankara, Turkey.

出版信息

J Pediatr Surg. 2020 Aug;55(8):1574-1578. doi: 10.1016/j.jpedsurg.2019.07.018. Epub 2019 Aug 13.

Abstract

AIM

We investigated the effects of hydrogen-rich saline solution (HRSS) on intestinal anastomosis performed after intestinal ischemia reperfusion injury (IRI).

MATERIALS AND METHODS

Thirty Wistar albino female rats were randomly divided into five groups. Only laparotomy was performed in the Sham group. In the other four groups, an intestinal IRI was performed for 45 min by clamping the superior mesenteric artery. After intestinal IRI, anastomosis was performed by cutting the intestine from the proximal 15 cm of the ileocecal valve at the first and 24th hours. HRSS was given intraperitoneally 5 ml/kg before reperfusion and for four more days in the HRSS and HRSSgroups, while no treatment was given to the I/R and I/R groups. After 5 days, all groups underwent relaparotomy. The anastomotic bursting pressures were measured in all groups, except the Sham group. The tumor necrosis factor-α (TNF-α), interleukin 6 (IL-6), myeloperoxidase (MPO) and malondialdehyde (MDA) levels were measured in the tissues taken from the anastomosis line. The tissue sections were evaluated histopathologically and the apoptosis index was determined by applying the TUNEL method. The results were analyzed one-way analysis of variance (ANOVA) and Pearson's chi-squared test.

RESULTS

Although the MPO, MDA, IL-6 and TNF-α tissue values were not statistically significant among the groups, the degree of tissue damage and apoptosis levels were lower and the anastomotic bursting pressures values were higher in the HRSS and HRSS groups compared to the I/R and I/R groups.

CONCLUSION

HRSS is effective in reducing the intestinal damage caused by an IRI: HRSS has the potential to reduce the detrimental effects of intestinal anastomosis performed after an intestinal IRI.

摘要

目的

研究富氢生理盐水(HRSS)对肠缺血再灌注损伤(IRI)后肠吻合术的影响。

材料和方法

30 只 Wistar 白化雌性大鼠随机分为 5 组。仅在 Sham 组进行剖腹手术。在其他四组中,通过夹闭肠系膜上动脉,使肠道缺血 45 分钟。在肠道 IRI 后,在第一次和第 24 小时,从回盲瓣近端 15cm 处切断肠道进行吻合。在再灌注前和再灌注后 4 天,HRSS 组和 HRSS 组给予腹腔内 5ml/kg HRSS,而 I/R 组和 I/R 组则不给予任何治疗。5 天后,所有组均进行再次剖腹手术。除 Sham 组外,所有组均测量吻合口破裂压。测量取自吻合线的组织中的肿瘤坏死因子-α(TNF-α)、白细胞介素 6(IL-6)、髓过氧化物酶(MPO)和丙二醛(MDA)水平。通过 TUNEL 法评估组织切片的组织病理学,并确定细胞凋亡指数。结果采用单因素方差分析(ANOVA)和 Pearson 卡方检验进行分析。

结果

尽管各组之间 MPO、MDA、IL-6 和 TNF-α 组织值无统计学意义,但与 I/R 和 I/R 组相比,HRSS 和 HRSS 组的组织损伤程度和细胞凋亡水平较低,吻合口破裂压较高。

结论

HRSS 可有效减轻 IRI 引起的肠道损伤:HRSS 有可能减轻肠道 IRI 后肠吻合术的不良影响。

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