大鼠胆肠吻合术后吻合口瘢痕形成的特点

Characteristics of anastomotic scar formation after bilioenteric anastomosis in rats

  • 摘要: 目的 通过对大鼠胆肠吻合术后吻合口胆管壁组织的动态观察,研究吻合口瘢痕形成的特点。 方法 共选用SD大鼠30只,随机分为5组(每组6只):正常组、胆肠吻合3 d组、1周组、2周组和1个月组。比较胆肠吻合术后各组不同时间点大鼠吻合口直径、吻合口胆管壁组织的Masson染色、TGF-β1免疫组化染色和TGF-β1的PCR相对定量情况。 结果 顺利完成各组实验手术操作。大鼠实施胆肠吻合术后吻合口直径逐渐缩窄,术后2周组和术后1个月组吻合口直径分别为(3.8±0.4) cm、(3.3±0.2) cm,明显窄于术后3 d组的(4.4±0.2) cm (P< 0.05)。Masson染色结果提示,胆肠吻合术后1个月胆管壁几乎完全瘢痕化。TGF-β1免疫组化染色及PCR定量结果提示,组织的瘢痕化随着时间的推移逐渐趋于稳定,术后1个月时TGF-β1的基因表达趋于正常。 结论 大鼠胆肠吻合术后,吻合口组织逐渐出现瘢痕化狭窄,术后1个月左右达到相对稳定状态,在术后1个月内阻断或减少吻合口组织的瘢痕化趋势,将有助于减轻术后吻合口瘢痕的形成,减少吻合口狭窄的发生。

     

    Abstract: Objective To study the characteristics of anastomotic scar formation after bilioenteric anastomosis in rats. Methods A total of 30 SD rats were randomly divided into 5 groups, including: normal group, 3 days group, 1 week group, 2 weeks group and 1 month group, with six rats in each group. The anastomotic diameter, results of Masson staining, TGF-β1 staining and TGF-β1 relative quantification of PCR were compared between each group at different time points after bilioenteric anastomosis. Results The operation was completed successfully. The anastomosis of rats after the operation narrowed gradually, and the anastomosis in 2 weeks group and 1 month group was significantly narrower than the 3 days group (3.8±0.4) cm, (3.3±0.2) cm vs (4.4±0.2) cm, P< 0.05. The results of Masson staining showed that the bile duct wall was almost completely scarring at 1 month after the operation. The TGF-β1 staining and PCR quantitative results showed that the scar of the anastomosis became more and more stable over time, and the gene expression of TGF-β1 gradually decreased to normal at 1 month after the operation. Conclusion The anastomosis in rats after bilioenteric anastomosis gradually develops to scar stenosis. Symptom of scarring is most obvious in 1 week after operation, and it becomes relatively stable at 1 month after operation. Blocking the trend of scarring will be helpful to alleviate the formation of anastomotic scar and reduce the incidence of anastomotic stricture in 1 month after operation.

     

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