摘要
目的研究内镜下纳米银支架治疗急性重症胆管炎(ACST)的机制及纳米银支架的抗菌性。方法将20头猪随机分为纳米银支架组(n=8)、普通支架组(n=8)和对照组(n=4)。对照组采用内镜下逆行胆管造影(ERC),胆总管内注入大肠杆菌,乳头口用钛夹夹闭,封闭乳头。支架组在造模成功后行ERC+支架置入,支架末端在乳头口处以钛夹固定。观察术后猪的一般情况,分别于术前、术后1 d、3 d、5 d采集猪血检测其白细胞计数、谷丙转氨酶(ALT)、碱性磷酸酶(ALP)、血清胆红素(TB)、血清肿瘤坏死因子(TNF-α)和白细胞介素-1(IL-1),观察猪死亡后的胆管病理改变。结果三组猪术前的各项观察指标比较差异均无统计学意义(P>0.05);术后对照组的白细胞及分类、ALT、ALP、TB、TNF-α和IL-1水平均逐步上升,且在各时点均明显高于两支架组,差异均有统计学意义(P<0.05);纳米银支架组和普通支架组在术后第五天白细胞计数及分类、血清TNF-α和IL-1比较差异均有统计学意义(P<0.05)。结论细菌感染和胆道梗阻是ACST的主要病因,内镜下置入支架治疗ACST,微创有效,纳米银支架有抗菌性。
Objective To study the mechanism of nano silver stents in the treatment of acute cholangitis of severe type（ACST） and the antibacterial property of nano silver stents under endoscope. Methods Twenty pigs were randomly divided into nano silver stent group（n=8）, ordinary stent group（n=8） and control group（n=4）. The control group was treated by endoscopic retrograde biliary imaging（ERC）, followed by injecting E. coli through bile duct and enclosing papilla with titanium clips. The nano silver stent group and ordinary stent group were treated by ERC combined with stent implantation, followed by enclosing papilla with titanium clips. The peripheral blood samples were collected pre-operatively and at 1 day, 3 day, 5 day post-operatively for detection of white blood cell（WBC）, alanine aminotransferase（ALT）, alkaline phosphate（ALP）, total bilirubin（TB）, tumor necrosis factor-α（TNF-α） and interleukin-1（IL-1）. The pathological changes of bile duct were observed when the pigs were executed. Results There were no significant differences between three groups pre-operatively. The changes of peripheral WBC, ALT, ALP, TB, TNF-α and IL-1 levels post-operatively in control group increased gradually, which were significantly higher than nano silver stent group and ordinary stent group（P〈0.05）. The changes of peripheral WBC, TNF-α and IL-1 levels in ordinary stent group and nano silver stent group showed statistically significant difference at 5 day post-operatively（P〈0.05）. Conclusion Infection and biliary obstruction are the main cause of ACST. Endoscopic stent implantation is minimally invasive for treating ACST, and nano silver stent has antimicrobial properties.
出处
《海南医学》
CAS
2015年第23期3433-3436,共4页
Hainan Medical Journal
基金
2013年海南省卫生厅课题(编号:琼卫2013-资助032号)
关键词
重症胆管炎
内镜
纳米银
支架
抗菌性
Acute cholangitis of severe type
Endoscope
Nano silver
Stent
Antibacterial property
