术后早期腹腔化疗下联合应用生长激素和生物蛋白胶对结肠吻合口愈合的影响

目的研究联合应用生长激素(GH)和生物蛋白胶(FS)对术后早期腹腔化疗条件下结肠吻合口愈合的影响。方法Wister大鼠48只,随机分为4组：对照组,单纯行肠切除吻合；腹腔化疗组(5-FU组),术后连续3 d腹腔内注射氟尿嘧啶(5-FU)(20 mg·kg~(-1)·d~(-1))；FS组,术中应用FS、术后给予早期腹腔化疗；GH联合FS组,术中应用FS、术后给予GH(1 mg·kg~(-1)·d~(-1))及早期腹腔化疗。术后8 d处死各组大鼠,剖腹切取吻合口进行评分(评分越高提示吻合口与周围组织的粘连越重)和测量吻合口破裂压力及进行吻合口组织学评分。结果GH联合FS组的吻合口评分2．00,低于FS组(2．13)和对照组(2．38),但P＞0．05,差异无统计学意义；GH联合FS组显著低于5-FU组的2．75,P＜0．05；差异有统计学意义。GH联合FS组的吻合口破裂压力229．9475,高于对照组(199．7525)和FS组(199．4338),P＜0．05；显著高于5-FU组(171．7938),P＜0．01。GH联合FS组的吻合口组织学评分2．9,高于FS组(2．3)和对照组(2．1)及5-FU组(1．7),P＜0．05。结论联合应用GH和FS能提高吻合口愈合强度,促进术后早期腹腔化疗条件下结肠吻合口的愈合。

Effects of fibrin glue and growth hormone on the healing of colon anastomoses in the condition of immediate postoperative intraperitoneal chemotherapy

OBJECTIVE: To investigate the effects of fibrin glue and growth hormone on the healing of colon anastomoses after immediate postoperative intraperitoneal chemotherapy. METHODS: Forty-eight rats were randomly divided into 4 groups, and received colon resection and anastomosis(control group),or early postoperative intraperitoneal chemotherapy(EPIC) with 5-Fu(20 mg*d kg-1*d-1) for 3 days after operation (chemotherapy group), or coverage of the stoma with fibrin glue and then EPIC(FG group), coverage of the stoma with fibrin glue and then EPIC plus subcutaneous injection of growth hormone(1 mg*d kg-1*d-1)(GH group). All the rats were killed on the 8th postoperative day, and adhesion formation score, bursting pressure of the stoma, and histological score were investigated. RESULTS: The adhesion formation score in chemotherapy group was significantly higher than those in the other three groups(P< 0.05); but there was no significant difference among the other three groups(P > 0.05). The bursting pressure of the stoma was significantly higher in GH group than those in the other three groups; and significantly higher in FG group and the control group than that in chemotherapy group. The histological score of the stoma in GH group was significantly higher than those in the other three groups(P< 0.05). CONCLUSION: Fibrin glue in combination with growth hormone can enhance the strength of the stoma and improve the healing of colon anastomoses in the condition of early postoperative intraperitoneal chemotherapy.