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本文研究单层吻合术对肠管愈合的可靠性。笔者用Wistar鼠24只,提取一段小肠分别行单、双层吻合术。动物随机分6组,分别于术后1～6天测吻合口破裂压力,取标本行光镜及电镜观察,结果动物全部存活。术后4日单、又层吻合口抗破裂压力最低,分别为:108.70±32.6mmHg,109.30±48.8mmHg;术后6日单、双层吻合口抗破裂压力最高,分别为:227.20±40.1mmHg,201.50±22.9mmHg。电镜下见,单层吻合口粘膜层于术后3日开始对合愈合。光镜下见,其肠壁各层对合良好,粘膜上皮细胞向对侧爬行;术后5日大量纤维充填吻合口。电镜下见,双层吻合口粘膜层于术后4日开始愈合。光镜下见,其肠壁各层对合不良,间距大;术后6日大量纤维充填吻合口。笔者认为,单层吻合与双层吻合比较,各层组织对合好,有利于吻合口间隙纤维母细胞充填,粘膜愈合快,且4日内二者吻合口抗破裂压力相同。
This article studies the reliability of single-layer anastomosis on bowel healing. I used 24 Wistar rats, extraction of a small intestine were single and double anastomosis. The animals were randomly divided into 6 groups. The anastomotic rupture pressure was measured at 1 ~ 6 days postoperatively. The specimens were examined with light microscope and electron microscope. The animals were all alive. The anti-rupture pressure of single and double anastomosis was the lowest on the 4th postoperative day, which were 108.70 ± 32.6mmHg and 109.30 ± 48.8mmHg, respectively. The single and double layer anastomoses at 6th postoperative had the highest rupture pressure of 227.20 ± 40.1mmHg , 201.50 ± 22.9 mmHg. Electron microscope, monolayer anastomosis mucosa in the first 3 days after surgery to heal. Light microscopy, the layers of the wall of the well, mucosal epithelial cells to the opposite side of the line; a large number of fibers after 5 days filling anastomosis. Electron microscope see, double anastomosis mucosa at 4 days after the start of healing. Light see, the layers of the wall of the poor combination, spacing; a large number of fibers after 6 days filling anastomosis. The author believes that single-layer anastomosis and double-layer anastomosis, the layers of a good fit, is conducive to anastomotic interstitial fibroblasts filling, mucosal healing fast, and within 4 days the two anastomotic anti-rupture pressure the same.