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目的探讨腹腔镜建造犬胆道梗阻模型的可行性及其与开腹方式相比的优越性。方法将16只本地健康杂种犬随机分为2组,每组8只,分别行腹腔镜或开腹胆总管结扎术,比较2组手术时间、术后并发症、术后麻醉复苏、术后胃肠道恢复情况,以及术前、术后不同时间点白细胞、C反应蛋白(C-reactive protein,CRP)及血清降钙素原(procalcitonin,PCT)水平,术后10天进行大体观粘连Nair分级并取组织行病理学观察。结果与开腹组相比,腹腔镜组手术时间短[(39.6±3.1)min vs.(69.4±8.6)min,t=-9.183,P=0.001],麻醉苏醒早[(58.8±10.9)min vs.(92.4±13.9)min,t=-5.380,P=0.001],术后首次自主进食早[(3.6±0.6)h vs.(6.8±1.1)h,t=-7.439,P=0.001],首次排便早[(1.0±0.0)d vs.(1.9±0.6)d,t=-3.862,P=0.006],各时点白细胞、CRP、粘连指数Nair评分、结扎部位胆道组织病理学分级,腹腔镜组均优于开腹组且具有统计学意义(P<0.05),各时间点PCT、肝功能、胆红素水平2组差异无显著性(P>0.05)。结论腹腔镜建造犬胆道梗阻模型是一种微创、简便的方式,炎症水平及腹腔粘连程度较低,有利于二次手术和进一步实验研究。
Objective To explore the feasibility of laparoscopic model of biliary obstruction in dogs and its superiority compared with the open method. Methods Totally 16 local healthy mongrel dogs were randomly divided into 2 groups with 8 rats in each group. Laparoscopic or open bile duct ligation was performed. The operative time, postoperative complications, postoperative anesthesia recovery, postoperative stomach Intestinal recovery and the levels of leukocyte, C-reactive protein (CRP) and procalcitonin (PCT) at different time points before and after surgery. The gross adhesion Nair classification was performed 10 days after operation Observe histopathology. Results Compared with the open group, laparoscopic group had shorter operative time (39.6 ± 3.1) min vs. (69.4 ± 8.6) min, t = -9.183, P = 0.001] (P <0.001). The mean duration of postoperative self-administration was (3.6 ± 0.6) h vs. (6.8 ± 1.1) h, t = -7.439, P = 0.001] (1.0 ± 0.0) d vs. (1.9 ± 0.6) d, t = -3.862, P = 0.006]. The white blood cells, CRP, Nair score at each time point, histopathological grade of biliary tract in the ligation site, The laparoscopic group was superior to the open group and had statistical significance (P <0.05). There was no significant difference in PCT, liver function and bilirubin between the two groups at all time points (P> 0.05). Conclusion Laparoscopic construction of biliary obstruction model in dogs is a minimally invasive and simple way, the level of inflammation and abdominal adhesions is low, which is conducive to secondary surgery and further experimental study.