生长抑素治疗术后早期炎性肠梗阻45例

Effect of fast track surgery on early postoperative inflammatory small bowel obstruction

AIM

To explore the effect of fast track surgery (FTS) on early postoperative inflammatory small bowel obstruction (EPISBO) in patients with abdominal surgery and to recognize the clinical features of EPISBO.

METHODS

The clinical data for 43 patients with EPISBO were retrospectively analyzed after abdominal operation at our hospital from March 2010 to April 2015. These patients were divided into two groups based on whether FTS was adopted or not: FTS group and routine treatment group (control group). Changes in serum C-reactive protein (CRP) and gastrointestinal dysfunction score were recorded before treatment and at 72 h after treatment and compared between the two groups. Time to first anal exhaust, time to defecation, time to recovery of bowel sound, time to stop gastrointestinal decompression, complication rate, and reoperation rate were also recorded and compared.

RESULTS

Abdominal surgery, particularly gastrointestinal surgery, is likely to be associated with EPISBO. Before treatment, serum CRP and gastrointestinal dysfunction score had no significant differences between the two groups (P > 0.05); however, 72 h after treatment, serum CRP and gastrointestinal dysfunction score differed significantly between the two groups (P < 0.05 and P < 0.01, respectively). After treatment, time to gastrointestinal function recovery was statistically significant between the two groups (P < 0.01). Main complications occurring in the two groups were bleeding and recurrent intestinal obstruction. The overall complication rate was 13.04% for the FTS group and 35.00% for the control group, and the reoperation rates were 4.35% and 15.00%, respectively. No intestinal fistula occurred in the FTS group.

CONCLUSION

EPISBO is a kind of inflammatory intestinal obstruction that can be cured by non-operative treatment. FTS plays a significant role in improving the prognosis of EPISBO and accelerating EPISBO recovery.

Expression of EGF and somatostatin in the submandibular gland of rats during heroin abstinence, detoxification or relapse

AIM: To investigate the expression of epidermal growth factor (EGF) and somatostatin in the submandibular gland of rats during heroin abstinence, detoxification or relapse.

METHODS: Male rats were divided into normal control group (NCG, n = 5), saline control group (SCG, n = 5), and experiment group (EG). The EG group was further divided into heroin abstinence group (HAG, n = 5), methadone detoxification group (MDG, n = 5), and heroin relapse group (HRG, n = 5). Submandibular gland tissue samples were taken from each group to perform immunohistochemistry to detect the expression of EGF and somatostatin.

RESULTS: Compared to the NCG group, the immunostaining density of EGF- and SS-positive cells was greater, the mean grey degree of EGF- and SS-positive cells decreased (EGF: 71.21 ± 9.31 vs 153.59 ± 11.00, 144.35 ± 7.54, F = 37.444; SS: 158.62 ± 10.95 vs 149.19 ± 9.00, 136.73 ± 7.93, F = 19.260; all P < 0.05), and the number of EGF-positive cells significantly increased (52.13 ± 5.33 vs 60.96 ± 6.06, 58.87 ± 5.69, F = 10.363, both P < 0.05) in the HAG and HRG groups. The number of SS-positive cells significantly increased (NCG45.68±5.70 vs HAG56.68±4.31, F = 11.201, P < 0.05) in the HAG group but showed no significant changes in the HRG group (P > 0.05) compared to the NCG group. In addition, the mean grey degree of EGF- and SS-positive cells did not change significantly in the MDG group (P > 0.05).

CONCLUSION: Heroin abstinence and relapse significantly affect the synthesis and secretion of EGF and SS in the submandibular gland of rats.