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目的 观察一期手术经肛吻合口上、下置管肠腔内双管引流对狗乙状结肠火器伤并海水浸泡后的治疗效果。方法 手枪射击致狗开放性乙状结肠伤 ,再经海水浸泡 1h。对照组 8只狗予清创切除 ,一期吻合乙状结肠 ;处理组 8只狗在清创切除和一期吻合乙状结肠时 ,经肛于吻合口上、下置管行肠腔内双管引流。术后第 3,7天观察两组狗吻合口及其周围炎症反应、吻合口两端肠腔内滞留物和血浆内毒素 (ET)、肿瘤坏死因子 (TNF)含量变化。结果 处理组肠腔内容物无明显淤积 ,血浆 ET、TNF水平均明显低于对照组 (P<0 .0 1) ,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 一期手术经肛吻合口上、下双管引流法能较有效地治疗乙状结肠火器伤并海水浸泡
Objective To observe the effect of double-tube drainage in the intestine of upper and lower intestine after an anastomotic anastomosis on firearm sigmoid colon fire and seawater immersion. Methods Pistol shooting dogs open sigmoid colon injury, then soaked in seawater 1h. The control group of 8 dogs were debridement resection, an anastomosis of sigmoid colon; the treatment group of 8 dogs in debridement and anastomotic sigmoid colon, the anus in the anastomosis, the catheter placed under the intestinal canal drainage. At 3 days and 7 days after operation, the anastomotic and surrounding inflammatory reaction, the contents of intestinal lumen, plasma endotoxin (ET) and tumor necrosis factor (TNF) in the two groups were observed. Results There was no obvious deposition of intestinal contents in the treatment group. The plasma levels of ET and TNF in the treated group were significantly lower than those in the control group (P <0.01). The edema of the intestinal wall subsided quickly. The anastomotic inflammation was mild and the incidence of anastomotic leakage was significant reduce. Conclusions The first operation of anastomosis through the anastomosis of the upper and lower double-tube drainage can be more effective treatment of sigmoid colon fire and seawater immersion