Jonsson T, Högström H, Zederfeldt B
Department of Surgery, Lund University, Malmö General Hospital, Sweden.
Eur Surg Res. 1993 May-Jun;25(3):169-73. doi: 10.1159/000129274.
Suture-holding capacity (breaking strength) of small bowel anastomoses made with interrupted or continuous sutures was assessed in two groups of rats. The tightness of the suture line was varied in a standardized manner in both groups. All types of anastomoses had similar strength immediately after surgery. After 72 h, suture-holding capacity had decreased by 50-55% (p < 0.001) in tightly sutured anastomoses and by 10-15% (p > 0.05) if sutures were loose. Changes in strength were similar regardless of whether interrupted or continuous sutures were used. Myeloperoxidase activity, reflecting tissue neutrophil accumulation, and hydroxyproline content were similar in all types of anastomoses after 72 h. Deterioration of early anastomotic strength is probably due to proteinase-mediated tissue degradation. It is speculated that tight sutures encourage proteolytic enzyme activity in the bowel wall by disturbing the local proteinase/proteinase inhibitor balance.
在两组大鼠中评估了用间断或连续缝线进行小肠吻合术的缝线持力（断裂强度）。两组均以标准化方式改变缝线处的紧密度。所有类型的吻合术在术后即刻具有相似的强度。72小时后，紧密缝合的吻合术的缝线持力下降了50 - 55%（p < 0.001），而缝线宽松时下降了10 - 15%（p > 0.05）。无论使用间断还是连续缝线，强度变化相似。72小时后，反映组织中性粒细胞积聚的髓过氧化物酶活性和羟脯氨酸含量在所有类型的吻合术中均相似。早期吻合口强度的恶化可能是由于蛋白酶介导的组织降解。据推测，紧密缝线通过扰乱局部蛋白酶/蛋白酶抑制剂平衡而促进肠壁中的蛋白水解酶活性。
