肠管局部切开不同缝合方式的对比研究

目的本课题通过建立动物模型，观察不同缝合方式对肠管愈合的影响，探讨两种不同缝合方式的优劣，以进一步寻找更好的缝合方式，为手术提供更好的选择。 方法一期手术分别建立纵切横缝及纵切纵缝的动物模型，然后二期手术获取瘢痕标本。分别通过观察缝合处炎症粘连情况、记录瘢痕评分、肠管的容积、肠管内径以及不同缝合方式的瘢痕的病理表现，从而选择出更好更加美容的缝合方式。 结果纵向缝合与横向缝合相比，纵向缝合所需的缝合时间较短；瘢痕评分较低；纵向缝合肠管内周径较短。横向缝合与纵向缝合相比，二者在肠管容积和肠管局部粘连方面无明显差异。从病理上来看，纵向缝合的黏膜下层产生了大量的成纤维组织，排列尚为整齐。横向缝合黏膜下层大量的成纤维组织增生，增厚，排列紊乱，大量片状炎症细胞浸润，肌层轻度水肿。 结论纵向缝合是一种快捷，有效的的缝合方法。在相同的缝合线下，纵向缝合可减轻因手术创伤而引起的炎症反应，降低了术后瘢痕增生的程度；纵向缝合更加符合解剖结构，使组织相容性更好。

Comparative study of different suturing techniques after partial bowel incision

ObjectiveThe aim of our experiment is to study the effects of different suture on the healing of intestinal through establishing animal models, and then to compare two different ways of intestinal suture so that to find a better choice for surgery. MethodOn the first stage of surgery, animal models were established, which one is longitudinal cut bowel and transverse suture and the other is longitudinal cut and longitudinal suture.On the second stage of surgery, we got the cicatrix specimens from the animal models.We compared the two different ways of suture by comaring inflammation and adhesions around the stitching bowel, cicatrix score, the volume of bowel, inside diameter and bowel cicatrix pathology, so that to choose a better way of suture. ResultLongitudinal suture cost less operation time, had a lower cicatrix score and a smaller inside diameter of bowel compared with transverse suture.There were no difference in the volume of bowel and adhesions around the stitching bowel.Viewing the bowel cicatrix pathology, the submucosa of longitudinal suture bowel had a large amount of fibrous tissue which was neatly arranged, while the submucosa of transverse suture bowel had a large amount of fibrous tissue which was hyperplasia, thickening, disorganized and contained a large sheet of inflammatory cell infiltration with muscle edema. ConclusionLongitudinal suture is a quick and effective method of stitching.Longitudinal suture can reduce surgical trauma caused by inflammation while using the same seam and reduce the extent of cicatrix hyperplasia.Longitudinal suture meets the anatomical structure so that it has a better histocompatibility.