Holmes N J, Cazi G, Reddell M T, Gorman J H, Fedorciw B, Semmlow J L, Brolin R E
Department of Surgery, UMDNJ-Robert Wood Johnson Medical School, CN 19 New Brunswick 08903.
J Invest Surg. 1993 Mar-Apr;6(2):211-21. doi: 10.3109/08941939309141610.
Viability of ischemic bowel was assessed in 30 dogs after mesenteric arterial ligation in a 40-cm length of ileum. Viability was evaluated using two gross features, color and peristalsis, and four objective methods including bowel wall surface oximetry (pO2), Doppler ultrasound, quantitative fluorescein fluorimetry, and myoelectric activity measured by a strain gauge probe. Each parameter was measured at 2-cm intervals within the 40-cm ischemic segment before resection and anastomosis was performed. There were seven fatal anastomotic leaks, all due to further bowel necrosis. Survival did not correlate with bowel color, presence of peristalsis, bowel wall pO2 Doppler ultrasound, or the myoelectric parameters. However, fluorescein fluorimetry was predictive of long-term viability. These results suggest that quantitative fluorescein fluorimetry may be a useful adjunct in intraoperative bowel viability assessment.
在30只狗身上，通过结扎肠系膜动脉使40厘米长的回肠缺血，以此评估缺血肠段的存活能力。利用颜色和蠕动这两个大体特征以及四种客观方法来评估存活能力，这四种方法包括肠壁表面血氧测定法（pO2）、多普勒超声、定量荧光素荧光测定法以及用应变仪探头测量的肌电活动。在切除和吻合手术之前，在40厘米缺血段内每隔2厘米测量每个参数。有7例致命的吻合口漏，均因肠管进一步坏死所致。存活率与肠管颜色、蠕动情况、肠壁pO2、多普勒超声或肌电参数均无相关性。然而，荧光素荧光测定法可预测长期存活能力。这些结果表明，定量荧光素荧光测定法可能是术中评估肠管存活能力的一种有用辅助方法。
