摘要
目的 建立稳定的大鼠结直肠切除、回肠J型贮袋肛管吻合术(Ileal J pouch-anal anastomosis,IPAA)模型.方法 选取体质量310~340 g的清洁级雄性SD大鼠60只,随机分为IPAA手术组和对照组.其中IPAA组30只,行结直肠切除、回肠J型贮袋制作、回肠贮袋直肠残端吻合作为IPAA模型,对照组30只,行开关腹手术.观察术后24 h、7 d、30 d大鼠存活率,记录手术时长、术后大鼠体重、进食量、饮水量及粪便评分变化.术后30 d经肛门造影评估回肠贮袋情况.切取IPAA组贮袋和对照组末端回肠行组织病理学检查.结果 IPAA组手术耗时(158.74±7.68)min,术后24 h、7 d、30 d大鼠存活率分别为100%、96.67%、90%.IPAA组大鼠体重于术后9 d左右降至最低(230.47±5.18)g,平均降幅为(98.43±4.06)g,21 d左右恢复至术前体重;进食量和饮水量术后逐渐增加,于9 d左右趋于正常;术后7 d粪便评分显著高于对照组(1.63±0.49比0.20±0.42,P<0.001),30 d时则无明显差异(P>0.05).回肠贮袋造影示贮袋充盈良好、无吻合口漏.病理结果示贮袋黏膜绒毛钝化变矮融合,潘氏细胞减少,而对照组末端回肠黏膜未见异常.结论 成功建立大鼠回肠J型贮袋肛管吻合术模型,可较理想地模拟人IPAA手术.
Objective To establish stable model of proctocolectomy and ileal J pouch-anal anastomosis(IPAA)in rats.Methods Sixty male specific pathogen free Sprague Dawley rats,weighting between 310 g and 340 g,were randomly divided into IPAA group(n=30,undergoing proctocolectomy,ileal J-pouch formation and ileal pouch-recta stump anastomosis)and control group(n=30,undergoing sham operation).Survival rates of rats at postoperative 24-h,7-d,30-d were observed.Operation time,and postoperative body weight,food-intake,water-intake and fecal scores were recorded as well.Transanal radiography was performed to estimate the condition of ileal pouch after 30 days of surgery.Ileal pouch specimens of IPAA group and terminal ileum specimens of control group were obtained for histological assessment.Results In IPAA group,operation time was(158.74±7.68)min.Survival rates of rats at postoperative 24-h,7-d,30-d were 100%,96.67%,90%respectively.Body weight decreased to the lowest(230.47±5.18)g at about postoperative 9-d with average amplitude of(98.43±4.06)g and recovered to preoperative body weight at about postoperative 21-d.Food-intake and water-intake increased gradually after surgery and reached normal quantities around 9 days postoperatively.Fecal score in IPAA group at postoperative 7-d was significantly higher than that in control group(1.63±0.49 vs.0.20±0.42,P<0.001),which was not significantly different at postoperative 30-d between two groups(P>0.05).Radiography showed filling-well ileal pouches without leakage.Histological results showed villous shortening and reduced Paneth cells in ileal pouch mucosa,and normal mucosa in terminal ileum specimens of control group.Conclusion Stable rat IPAA model is established successfully,which can more ideally simulate IPAA procedure in human beings.
作者
李凯钰
刘刚
王力田
何安琪
刘健
刘彤
Li Kaiyu;Liu Gang;Wang Litian;He Anqi;Liu Jian;Liu Tong(Department of General Surgery,Tianjin Medical University General Hospital,Tianjin 300052,China)
出处
《中华炎性肠病杂志（中英文）》
2017年第2期105-109,共5页
Chinese Journal of Inflammatory Bowel Diseases
基金
黎介寿院士肠道屏障研究专项基金(LJS_201008)。
