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目的 观察Ⅰ期手术经肛吻合口上、下置管肠腔内双管引流治疗合并海水浸泡犬结肠火器伤的效果。 方法 成年健康杂种犬 16只 ,采用手枪射击致其开放性乙状结肠伤 ,经海水浸泡 1h完成模型制作。将模型分为对照组和处理组 ,每组 8只。对照组清创切除Ⅰ期吻合乙状结肠 ,处理组清创切除Ⅰ期吻合乙状结肠时 ,经肛吻合口上、下置管肠腔内双管引流。术后第 3,7天观察吻合口及其周围炎症反应、吻合口两端肠腔内滞留物、肠腔压力和血清内毒素 (ET)、肿瘤坏死因子 (TNF)的变化。 结果 处理组肠腔内容物无明显淤积 ,吻合口上、下肠腔内压力和血清ET、TNF水平均明显低于对照组 (P <0 .0 5 ) ,肠壁水肿消退快 ,吻合口炎症反应轻 ,吻合口漏的发生率明显降低。 结论 Ⅰ期手术经肛吻合口上、下双管引流法能有效地治疗合并海水浸泡的结肠火器伤 ,明显减少术后吻合口漏的发生
Objective To observe the effect of stage Ⅰ surgery on the colon and intestine firearm wounds treated with seawater and double pipe drainage in the upper and lower anastomoses through the anastomotic anastomosis. Methods Twenty-six adult healthy mongrel dogs were treated with a pistol and their open sigmoid colon wounds were made. After soaking in seawater for 1h, the model was made. The model was divided into control group and treatment group, 8 in each group. Control group debridement resection of stage Ⅰ anastomosis sigmoid colon, the treatment group debridement resection of sigmoid anastomosis Ⅰ, the anastomosis through the anastomosis, the catheter placed in the intestine two-tube drainage. At 3 and 7 days after operation, the anastomotic and surrounding inflammatory reactions were observed. The contents of intestinal lumen, intestinal pressure and serum endotoxin (ET) and tumor necrosis factor (TNF) in the anastomosis were observed. Results The contents of intestinal lumen in the treatment group showed no obvious deposition. The pressure in the upper and lower intestine and the levels of ET and TNF in serum in the treatment group were significantly lower than those in the control group (P <0.05). The edema of the intestinal wall subsided quickly and the anastomotic inflammatory reaction Light, anastomotic leakage significantly reduced the incidence. Conclusions The operation of stage Ⅰ surgery through the anastomosis of the upper and lower sides of the anus and anastomosis can effectively treat the firearm wound of the colon with seawater immersion and significantly reduce the incidence of postoperative anastomotic leakage