影响结肠吻合口愈合因素的实验研究

通过建立左侧结肠切除再吻合之大鼠模型观察各种因素在吻合口愈合过程中所起的作用。结果提示：左侧结肠切除吻合术后第３、４天，吻合口的抗张强度及羟脯氨酸含量降至最低水平，此时易发生吻合口漏；抑肽酶、二甲基亚砜、超氧化物歧化酶及维生素Ａ均有促进结肠吻合口早期愈合的作用，维生素Ａ还可拮抗氢化考的松延迟结肠吻合口愈合的作用；围手术期化疗对结肠吻合口早期愈合无显著不良影响；左半结肠完全性梗阻行结肠一期切除吻合术，于吻合前行肠减压及吻合后用抗生素液作腹腔灌洗显然有利于吻合口早期愈合。

AN EXPERIMENTAL STUDY OF FACTORS CONTRIBUTING TO LEAKAGE OF COLONIC ANASTOMOSES

In a series of experiments on rats, we have observed that the tensile strength and hydroxyproline content of left colonic anastomosis presented the lowest level on the 3rd and 4th postoperative days. Aprotinin, dimethyl sulfoxide, superoxide dismutase and vitamin A could improve the early coures of healing of colonic anastomosis; hydroxycortisone could retard the early course of healing of anastomosis and vitamin A antagonize the deleterious effect as mentioned above. Perioperative chemotherapy did not impair the early course of healing of colonic anastomosis. The primary resection and anastomosis of left colon for complete obstruction could be safely done if colonic content was decompressed before performing anastomosis and abdominal cavity was irrigated with antibiotic solutions afterwards. The mechanism of some factors influencing the healing of colonic anastomosis is discussed.