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Objective To explore the impact of open and laparoscopic cholecystectomy of different operation methods on postoperative intestinal adhesions.Methods 128 patients with acute cholecystitis were randomly divided into the observation group (64 cases)and control group (64 cases).The control group was treated with open chole-cystectomy,the observation group was treated with laparoscopic cholecystectomy.The postoperative intestinal function, complications and intestinal adhesion were compared between the two groups.Results The bleeding amount,incision size,operation time of the observation group were (132.29 ±27.28)mL,(3.9 ±0.2)cm,(102.1 ±20.9)min,which were significantly better than those of the control group [(197.44 ±31.21 )mL,(15.4 ±2.3 )cm,(129.5 ± 30.6)min],the differences were statistically significant(t =12.574,38.850,5.915,P <0.05).The incision healing time,bowel sounds recovery time,exhaust time of the observation group were (8.65 ±0.75)h,(23.63 ±5.14)h, (31.65 ±10.71)h,which were significantly shorter than those of the control group [(13.27 ±1.18)h,(36.17 ± 7.14)h,(46.35 ±13.36)h],the differences were statistically significant (t =26.434,11.403,6.868,all P <0.05).The length of hospital stay and hospitalization expenses of the observation group were (3.9 ±1.6)d,(9 830 ± 840)RMB,which were significantly less than those of the control group [(5.7 ±2.4)d,(1 2876 ±703)RMB](t =4.992,22.247,all P <0.05).Conclusion Laparoscopic cholecystectomy can not only reduce intraoperative bleed-ing volume and operation time,promote postoperative intestinal function recovery,but also can save the cost of hospi-talization,reduce complications and the incidence of intestinal viscosity.Security is good,it is recommended.
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Objective To study curing effect of prevention for postoperative ankylenteron with Chymotrypsin and placonta tissue hydrolysate. Methods 311 postoperative patients were divided into two groups rondomly, 176 patients in the therapy group were perfused in abdominal cavity with Chymotrypsin and Placenta tissue hydrolysate,135 patients in the control group who were applied the routine intervention only,and then observed the rate of devdoping ankylenteron. Results The time of postoperative anus evacuate,the counting of white blood cell, the time of margin curing did not have marked ditferences(P>O.05), the rate of not develop ankylenteron in therapy group was higher than in control group(P <0.01). Conclusion The effect of perfused Chymotrypsin and Placenta tissue hydrolysate in abdominal cavity to obviate postoperative ankylenteron is remarkable
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Objective To observe the effect of Zhipu Hollow Suppository (ZHS) on postoperative ankylenteron in rats,and to investigate the possible mechanism.Methods Forty Wistar rats were randomly divided into model group,ZPS group,positive control group,and blank control group,10 rats in each group.Rats were given corresponding drugs according to the experimental design after modeling.Rats were executed after medication for one week,and the pathologic changes of ileal serosa were observed under scanning electron microscope and the ultrastructure of ileal serosa cells was observed under transmission electron microscope.Results Results of the examination under scanning electron microscope showed that the arrangement of ileal-serosa mesothelial cells in ZHS group was regular,and the network structure arranged spindle-shaped with uniformity size and with the shape close to the normal ones.There was proliferation in mesothelial cells in the exposed base layer.Under the transmission electron microscope,mesothelial cells recovered well and the proliferation of fibroblasts was not obviously in ZHS group,but mesothelial cells disappeared and the secretion of collagen by fibroblasts was actively in the model group.Conclusion ZHS can prevent ankylenteron by promoting the ileal-serosa mesothelial cell proliferation,improving the ileal-serosa ultrastructure and protecting the ileal serosa.
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Objective To observe the protective effect of rhein-arginine (RhA) on rats ankylenteron and to explore the anti-inflammatory mechanism. Methods Sixty male SD rats were randomly divided into 6 groups:normal control group,model group,dexamethasone group (in the dose of 10 mg?kg-1) and low-,medium-and high-dose RhA groups (in the dose of 7.5 mg?kg-1,15 mg?kg-1,30 mg?kg-1 respectively). Except that the normal control group,the rats in other groups were induced ankylenteron. Intraperitoneal injection of saline was administered to the rats in the normal control group and the model group,and dexamethasone group and RhA groups were given the corresponding drugs according to the experimental design. The treatment lasted 7 days. On the 8th day after surgery the blood samples of each group were collected. The levels of interleukin-1?(IL-1?),interleukin-4(IL-4)and tumor necrosis factor-?(TNF-a)were determined by enzyme linked immunosorbent assay. Grades of ntestinal adhesion were ranked by macroscopic observation. The adhesive tissues between cecum and abdominal wall were taken for pathological observation and the determination of hydroxyproline (Hyp) content. Results RhA significantly relieved the experimental intestinal adhesion,Obviously decreased the levels of IL-1?and TNF-?,and inhibited the hyperplasia of fibrous connective tissue. However,there was no significant impact on the level of IL-4. Conclusion RhA can effectively prevent the information of postoperative ankylenteron by inhibiting the expression of inflammatory cytokines and reducing the inflammatory response.