大鼠左半结肠与右半结肠吻合愈合能力的对比研究

目的 比较大鼠左半结肠和右半结肠吻合愈合的能力,为临床行结肠手术方式的选择提供理论依据.方法 将40只雄性Wistar大鼠随机分为A、B两组,每组20只.A组行右半结肠端端吻合,B组行左半结肠端端吻合.分别于术后第4天和第7天处死两组各10只动物,用免疫组化法测量吻合口组织中基质金属蛋白酶1(MMP-1)、MMP-13以及Ⅰ型胶原的表达,并同时进行组织病理学检查.结果 术后第4天,两组大鼠的左半结肠和右半结肠吻合口组织中MMP-1的表达分别为(1226±506)μm2和(732±376)μm2,两组之间比较差异有统计学意义(t=-2.54,P<0.05);两组MMP-13的表达分别为(1726±509)μm2和(1161±753)μm2,两组之间比较差异有统计学意义(t=-2.47,P<0.05);两组Ⅰ型胶原的表达分别为(199±90)μm2和(314±135)μm2,两组之间比较差异有统计学意义(t=2.30,P<0.05).术后第7天,两组大鼠的左半结肠和右半结肠吻合口组织中MMP-1的表达分别为(1264±508)μm2和(869±378)μm2,两组之间比较差异有统计学意义(t=-3.19,P<0.05);两组Ⅰ型胶原的表达分别为(228±79)μm2和(374±130)μm2,两组之间比较差异有统计学意义(t=2.61,P<0.05).结论 在结肠吻合术后,大鼠右半结肠吻合口组织中MMP-1和MMP-13的表达明显低于左半结肠,Ⅰ型胶原的表达明显高于左半结肠,提示右半结肠吻合愈合能力明显强于左半结肠.

The healing ability of left and right colonic anastomoses in rats

Objective To compare the healing ability differences between left colonic anastomosis and right colonic anastomosis in rats, in order to find a theoretical basis for the surgical management of colon resection. Methods Forty male Wistar rats were randomly divided into two groups: group A (end-to-end anastomosis of right colon, n=20), and group B (end-to-end anastomosis of left colon, n=20). Half of the rats in each group were sacrificed on the fourth day after operation, and the rest on the seventh day. The expressions of matrix metalloproteinase-1 (MMP-1), MMP-13 and collagen type Ⅰ were shown by immunohistochemical staining, and the histopathologic changes at the anastomosis were also demonstrated. Results The expression of MMP-1, MMP-13 at left colonic anastomosis was higher than that of MMP-1, MMP-13 at right colonic anastomosis, the expression of collagen type Ⅰ was lower than that of collagen type Ⅰ at right colonic anastomosis on the fourth day (P<0.05); The expression of MMP-1 at left colonic anastomosis was higher than that of MMP-1 at right colonic anastomosis, the expression of collagen type Ⅰ was lower than that of collagen type Ⅰ at right colonic anastomosis on the seventh day (P<0.05). Conclusions The healing ability of right colonic anastomosis is higher than that of left colonic anastomosis.