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目的研究联合应用生长激素(GH)和生物蛋白胶(FS)对术后早期腹腔化疗条件下结肠吻合口愈合的影响。方法Wister大鼠48只,随机分为4组：对照组,单纯行肠切除吻合；腹腔化疗组(5-FU组),术后连续3 d腹腔内注射氟尿嘧啶(5-FU)(20 mg·kg~(-1)·d~(-1))；FS组,术中应用FS、术后给予早期腹腔化疗；GH联合FS组,术中应用FS、术后给予GH(1 mg·kg~(-1)·d~(-1))及早期腹腔化疗。术后8 d处死各组大鼠,剖腹切取吻合口进行评分(评分越高提示吻合口与周围组织的粘连越重)和测量吻合口破裂压力及进行吻合口组织学评分。结果GH联合FS组的吻合口评分2．00,低于FS组(2．13)和对照组(2．38),但P＞0．05,差异无统计学意义；GH联合FS组显著低于5-FU组的2．75,P＜0．05；差异有统计学意义。GH联合FS组的吻合口破裂压力229．9475,高于对照组(199．7525)和FS组(199．4338),P＜0．05；显著高于5-FU组(171．7938),P＜0．01。GH联合FS组的吻合口组织学评分2．9,高于FS组(2．3)和对照组(2．1)及5-FU组(1．7),P＜0．05。结论联合应用GH和FS能提高吻合口愈合强度,促进术后早期腹腔化疗条件下结肠吻合口的愈合。
Objective To study the effect of combination of growth hormone (GH) and fibrin glue (FS) on the healing of colonic anastomosis after early intraperitoneal chemotherapy. Methods Forty-eight Wister rats were randomly divided into 4 groups: control group, simple bowel resection and anastomosis, intraperitoneal chemotherapy group (5-FU group), intraperitoneal injection of 5-fluorouracil (-1) · d -1 (-1) · d -1). In FS group, FS was given intraoperatively and early intraperitoneal chemotherapy was given postoperatively. (-1) · d ~ (-1)) and early intraperitoneal chemotherapy. Rats in each group were sacrificed on day 8 postoperatively. The anastomoses were dissected and incised for scoring (the higher the score, the more severe the adhesions of the anastomotic and surrounding tissues) and the anastomotic rupture pressure and the anastomotic histological score. Results The anastomotic score of GH combined with FS group was 2.00, which was lower than that of FS group (2.13) and control group (2.38), but the difference was not statistically significant 2.75 in 5-FU group, P <0.05; the difference was statistically significant. The anastomotic rupture pressure of GH combined with FS group was 229.9475, higher than that of control group (199.7525) and FS group (199.4338), P <0.05, significantly higher than that of 5-FU group (171.7938) P <0.01. The anastomotic histological score was 2.9 in GH combined with FS group, which was higher than that in FS group (2.3) and control group (2.1) and 5-FU group (1.7), P <0.05. Conclusions The combination of GH and FS can improve the anastomotic healing and promote the healing of colonic anastomosis under the condition of early postoperative chemotherapy.