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目的探讨结肠回肠反流后回肠末端黏膜结肠化的机制。方法取SD大鼠60只,均为雄性,体重250~300 g,随机分为实验组和对照组,分别进行末端回肠—盲肠侧侧吻合术或回肠末端手术缝线,2个月后处死动物并取组织进行观察。结果实验组术后一般状况良好。大体形态学观察:实验组回肠末端黏膜表现为绒毛萎缩、间距增宽、沟变浅、光滑性增强。病理组织学:实验组表现为黏膜绒毛萎缩、间距增宽、沟变浅、上皮细胞变短、杯状细胞增多。电镜观察:实验组可见绒毛变小、变短或脱落;微绒毛变短、分布不均匀;杯状细胞数目在非坏死区增多。结论结肠—回肠反流后可导致回肠末端黏膜结肠化的变化,它可能是慢性末端回肠炎的发病基础或前期表现。
Objective To investigate the mechanism of colonic mucosal colonization after ileum reflux in colonic ileum. Methods Sixty Sprague-Dawley rats, both male and weighing 250-300 g, were randomly divided into experimental group and control group. The animals were subjected to end-ileal-cecal anastomosis or distal ileal suture, and animals were sacrificed after 2 months And take the organization for observation. Results The experimental group was generally in good condition. Morphological observation: The experimental group of terminal ileum mucosa showed villous atrophy, broadened spacing, shallow ditch, smoothness enhanced. Histopathology: The experimental group manifested as mucosal villous atrophy, broadened spacing, shallow ditch, epithelial cells become shorter, goblet cells increased. Electron microscopy: the experimental group showed villus smaller, shorter or fall off; microvilli shorter, uneven distribution; goblet cells increased in the number of non-necrotic areas. Conclusion Colonic-ileal reflux can lead to the change of colonic mucosa in the terminal ileum. It may be the basis or early manifestation of chronic terminal ileitis.