Keshavarzian A, Gibson R, Guest J, Spencer J, Lavender J P, Hodgson H J
Dig Dis Sci. 1986 Mar;31(3):268-72. doi: 10.1007/BF01318118.
We have investigated the presence, duration, and clinical significance of granulocyte accumulation, using indium-111 granulocyte scanning, in patients following uncomplicated intestinal anastomosis. Eight patients underwent intestinal resection and anastomosis (right hemicolectomy, 5; sigmoid colectomy, 2; ileal resection, 1) for carcinoma, angiodysplasia, or perforation. All patients had an uneventful postoperative course, with no evidence of any leakage or infection. Indium-111 granulocyte scan and abdominal ultrasound were performed 7-20 days (12 +/- 4.7 means +/- SD) following surgery. Indium-111 granulocyte scan showed the presence of labeled granulocytes at the site of anastomosis in all patients. In three of eight, cells subsequently passed into the lumen of the bowel. In contrast, granulocytes were not visualized along the abdominal incision. Thus, in contrast to skin wounds, granulocytes continue migrating into the intestinal wall in areas of anastomosis for at least up to 20 days following surgical trauma. They may play a significant role both in healing the anastomosis and in preventing systemic bacterial infection. Moreover, indium-111 granulocyte scans following intestinal surgery should be interpreted with care, and the presence of labeled granulocytes around anastomoses does not necessarily indicate abscess formation.
我们采用铟 - 111 粒细胞扫描技术，对未发生并发症的肠吻合术后患者粒细胞聚集的存在情况、持续时间及临床意义进行了研究。8 例患者因癌症、血管发育异常或穿孔接受了肠切除及吻合术（右半结肠切除术 5 例；乙状结肠切除术 2 例；回肠切除术 1 例）。所有患者术后恢复顺利，无任何渗漏或感染迹象。术后 7 - 20 天（平均 12 ± 4.7 天，均值 ± 标准差）进行了铟 - 111 粒细胞扫描及腹部超声检查。铟 - 111 粒细胞扫描显示，所有患者吻合部位均有标记的粒细胞存在。8 例中有 3 例，细胞随后进入肠腔。相比之下，腹部切口处未观察到粒细胞。因此，与皮肤伤口不同，术后至少 20 天内，粒细胞持续向手术创伤后的吻合部位肠壁迁移。它们可能在吻合口愈合及预防全身性细菌感染方面发挥重要作用。此外，肠道手术后的铟 - 111 粒细胞扫描结果应谨慎解读，吻合口周围存在标记的粒细胞不一定表明形成了脓肿。
