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目的建立稳定的可复性小肠梗阻的新西兰白兔模型,要求其肠管的损伤和恢复程度呈现较明显的时间相关性和同步性。方法选取体重为2.5～3 kg的成年健康雄性新西兰白兔52只,其中假手术对照组4只,实验组48只。实验组白兔腹壁肌层切口(疝环的半周长)与待嵌顿肠管宽度相等,将长度为10 cm的末端回肠自腹肌切口处脱出埋置于皮下,形成腹壁嵌顿疝,模拟机械性小肠梗阻。根据肠管嵌顿和松解后的恢复时间,依次将实验模型分为8组,即嵌顿时间2 h、4 h、6 h、8 h组与在嵌顿肠管不可逆损伤临界点松解0 h、24 h、48 h、72 h组。通过病理检查,确定肠管损伤及恢复程度并进行分级,应用Ridit分析比较各组之间肠管损伤程度的差异。结果与假手术对照组相比,各实验组均呈现不同程度的肠管损伤。经Ridit分析,假手术对照组肠管损伤分级的平均Ridit值为0.071,梗阻组依嵌顿时间递增排序,自嵌顿2 h组至嵌顿8 h组,各组肠管损伤分级的平均Ridit值依次为0.327、0.545、0.735、0.890。通过方差分析中的LSD两两检验,可发现梗阻组与对照组相比,肠管损伤程度均存在统计学差异(P值均小于0.05);各梗阻组间,肠管损伤程度也均存在统计学差异(P值均小于0.05);而在肠管不可逆损伤临界点(梗阻6 h)松解后0 h、24 h、48 h、72 h组的平均Ridit值依松解时间递增排降序,为0.774、0.595、0.443、0.262。通过方差分析中的LSD两两检验,各梗阻后松解组间,肠管恢复程度也存在统计学差异(P<0.05)。结论本实验制备的可复性小肠梗阻新西兰白兔模型很好地模拟了肠梗阻的发展及及时松解后的恢复过程,肠管的损伤、恢复程度呈现出较明显的时间相关性及同步性。
OBJECTIVE: To establish a stable model of New Zealand white rabbits with reproducible small bowel obstruction, which requires a more obvious time correlation and synchronization between the intestinal injury and recovery. Methods 52 adult male New Zealand white rabbits weighing 2.5 ~ 3 kg were selected, including 4 sham operation control group and 48 experimental group. The experimental group rabbits abdominal wall muscle incision (hernia ring semi-circumference) and the length of the intestinal tract to be incarcerated, the length of 10 cm of the distal ileum from the abdominal incision at the subcutaneous embedded in the abdominal incarcerated hernia, the simulation of mechanical Small bowel obstruction. According to the recovery time after bowel incarceration and release, the experimental models were divided into 8 groups, ie, incarceration for 2 h, 4 h, 6 h, 8 h and irreversible damage in the incarcerated intestinal tract for 0 h , 24 h, 48 h, 72 h group. Through pathological examination to determine the degree of bowel injury and recovery and grading, Ridit analysis was used to compare the differences in the degree of bowel injury. Results Compared with the sham operation control group, all the experimental groups showed different degrees of bowel injury. According to Ridit analysis, the average Ridit value of bowel injury grading in sham operation control group was 0.071, and the obstruction group was sorted according to the time of incarceration. From 2 h incarceration group to 8 h incarceration group, the average Ridit value of bowel injury grading 0.327, 0.545, 0.735, 0.890. By LSD analysis of ANOVA, we found that there were significant differences in intestinal injury between obstructive group and control group (all P values were less than 0.05). There was also a statistically significant difference in intestinal injury between obstructive groups (P <0.05). However, the mean Ridit values at 0 h, 24 h, 48 h and 72 h after the irreversible injury of the intestine were significantly increased (P <0.05) 0.595, 0.443, 0.222. By LSD analysis of variance two-two test, after the release of obstruction group, the degree of intestinal recovery there is also a statistically significant difference (P <0.05). CONCLUSIONS: The New Zealand white rabbits model of reimplantable small bowel obstruction prepared in our study well simulated the development of intestinal obstruction and the recovery process after timely release. The damage and recovery of intestine showed a significant temporal correlation and synchronization.