经皮经肝穿刺胆道引流管周腹膜组织粘连实验研究

目的探讨经皮经肝穿刺胆道引流管周围组织组织粘连情况及其与时间关系,以期为临床缩短经皮经肝胆道内镜(PTCS)治疗间期的可行性提供科学实验依据。方法雄性小家猪随机分为4组:即术后第3、5、7、14 d共4组。开腹逆行穿刺置管形成模型,观察引流管周围腹膜之间的组织组织粘连情况并分级。结果所有模型管周腹膜间出现组织粘连,注入美蓝未见变色,而除管周外其他腹膜间没有组织粘连。其中3 d组组织粘连以Ⅱ级为主;5 d后各组组织粘连以Ⅲ级为主。经秩和检验统计学分析示3 d组与其他各组比较,差异有统计学意义(D≥176.2,P<0.05);5 d组、7 d组及14 d组组间比较,差异无统计学意义(D<176.2,P>0.05)。结论经皮经肝穿刺胆道引流(PTCD)术后第5 d经皮肝穿刺胆道引流引流管周围己形成完整致密组织粘连。

A experimental study on the adherence around catheter after percutaneous transhepatic cholangiodrainage

Objective To investigate the adherence around catheter after percutaneous transhepatic cholangiodrainage(PTCD).Methods Twenty-four male pigs were randomized into 4 groups and observed for the adherence around catheter on day 3,5,7 and 14 after PTCD respectively.Results There was not adhesion except between the two peritoneums and around the tube in all models.There were ten cases at grade II and two cases at grade III in 3 days after PTCD,one case at grade II and eleven at grade III in 5 days after PTCD,twelve cases at grade III in 7 days after PTCD,four cases at grade III and eight cases at grade IV in 14 days after PTCD,respectively.There was significant difference between the 3 day group and other groups(D>176.2,P<0.05),and there was no difference among the groups on day 5,7 and 14 after PTCD(all D<176.2,P>0.05).Conclusions The tight adherence around catheter is formed in 5 days after PTCD.