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[细菌感染对支气管残端愈合的影响及机械吻合器的应用价值]

[The effects of bacterial infection in bronchial stump healing and the usefulness of the mechanical stapling device].

作者信息

Kurita M

机构信息

Third Department of Surgery, Toho University, School of Medicine, Tokyo, Japan.

出版信息

Nihon Geka Gakkai Zasshi. 1994 Jan;95(1):21-9.

PMID:8309468
Abstract

It is an important problem to associate bacterial infection in the process of bronchial stump healing. Wound healing processes in two types of bronchial stump closure methods, hand suturing with absorbable threads and mechanical stapling with stainless steel staples, were compared in mongrel dogs (154 dogs) which underwent right upper lobe reactions with and without infections. Half of the animals were infected with 10(9) CFU/dog of Pseudomonas aeruginosa E7 organisms. In order to understand the influence of bacterial infection on bronchial stump healing and also to evaluate the usefulness of the mechanical stapling device, we studied the number of viable bacteria, the activities of collagenase types I, II, III and IV, the amount of hydroxyproline and the histopathological finding in the bronchial stump tissue and the maximum leakage pressure. The number of viable bacteria decreased daily, but more than 10(3) CFU/g were detected even on the 21st day in infected dogs. There were no organisms detected in the stump tissues of uninfected dogs. The maximum leakage pressure levels by the 14th day after operation in the infected group were lower than in the uninfected group regardless of closure method. In the infected group of mechanical stapling the maximum leakage pressure increased daily, and on the 21st day became almost equal to that of uninfected group of mechanical stapling. The activity levels of collagenase type I in the infected group of both methods were at a maximum on the 5th day. On the same day the amount of hydroxyproline was at a minimum, and maintained a low level until the 14th day.(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

在支气管残端愈合过程中,细菌感染是一个重要问题。我们在154只杂种犬中比较了两种支气管残端闭合方法(用可吸收线手工缝合和用不锈钢钉机械吻合)的伤口愈合过程,这些犬进行了右上叶切除,部分伴有感染,部分没有感染。一半的动物感染了每只10⁹CFU的铜绿假单胞菌E7菌株。为了了解细菌感染对支气管残端愈合的影响,并评估机械吻合装置的实用性,我们研究了支气管残端组织中活菌数量、I、II、III和IV型胶原酶的活性、羟脯氨酸含量、组织病理学表现以及最大漏气压。感染犬的活菌数量每日减少,但即使在第21天仍能检测到每克超过10³CFU。未感染犬的残端组织中未检测到细菌。无论闭合方法如何,感染组术后第14天的最大漏气压水平均低于未感染组。在感染的机械吻合组中,最大漏气压每日升高,在第21天几乎与未感染的机械吻合组相等。两种方法的感染组中,I型胶原酶的活性水平在第5天达到最高。同一天,羟脯氨酸含量最低,并一直维持在低水平直到第14天。(摘要截短于250字)

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