Albert A, Julia M V, Morales L, Parri F J
Division of Pediatric Surgery, Hospital Clínic, Universidad de Barcelona, Spain.
J Pediatr Surg. 1993 May;28(5):656-9. doi: 10.1016/0022-3468(93)90024-f.
The short, thick, matted bowel, often found in gastroschisis, has been attributed to a variety of factors. We designed an original animal model in order to isolate the effect of amniotic fluid on the fetal bowel. We created experimental gastroschisis in fetal rabbits. Extruded bowel was kept out of the amniotic sac in half of the operated fetuses. At term, 7 days after surgery, 21 surviving fetuses (12 intraamniotic gastroschisis [IAG] and 9 extraamniotic gastroschisis [EAG]) and 16 control littermates were collected for study. Five parameters were measured in each animal: body weight, intestinal weight, intestinal length, bowel diameter, and bowel wall thickness. Fetal mortality due to the extraamniotic fixation technique was 25%. We found no statistically significant difference in body weight, intestinal weight, or bowel wall thickness. An enormous difference was found in intestinal length (P < .0001 among the three groups). Bowel diameter was significantly different (P = .02) in the extreme groups (IAG and controls), with the intestine being more dilated in IAG than in EAG and controls. Gastroschisis in the absence of amniotic fluid was not as damaging to the fetal intestine as "natural" intraamniotic gastroschisis.
在腹裂中常见的短而粗、相互缠结的肠管被认为是由多种因素导致的。我们设计了一种原始动物模型，以分离羊水对胎儿肠管的影响。我们在胎兔身上制造了实验性腹裂。在一半接受手术的胎儿中，将挤出的肠管置于羊膜囊外。足月时，术后7天，收集21只存活胎儿（12只羊膜内腹裂[IAG]和9只羊膜外腹裂[EAG]）以及16只对照同窝仔兔进行研究。对每只动物测量五个参数：体重、肠重、肠长度、肠直径和肠壁厚度。羊膜外固定技术导致的胎儿死亡率为25%。我们发现体重、肠重或肠壁厚度没有统计学上的显著差异。三组之间肠长度存在巨大差异（P <.0001）。极端组（IAG和对照组）的肠直径有显著差异（P = 0.02），IAG组的肠管比EAG组和对照组更扩张。无羊水情况下的腹裂对胎儿肠管的损害不如“自然”羊膜内腹裂严重。
