Reliable anastomosis of esophageal reconstruction using laser Doppler flowmetry

前言：前列腺素E_1(PGEI)是一种新型的前列腺素E_1制剂，它与脂类结合，以减缓前列腺素E_1的释放，延缓其代谢速度。目的：观察生理盐水、前列腺素E_1和前列腺素E_1脂微球对猪缺血胃管微循环损伤的影响。材料和方法：15头家猪在全身麻醉下建立胃管，以0.05min/kg/μ的速率持续滴注生理盐水、前列腺素E_1和前列腺素E_1脂微循环10分钟。分别于给药前、给药后10min、给药结束后10min测定组织血流量(TBF)和血清前列腺素E_1(PGE1)浓度。而未修饰前列腺素E_1和脂微球前列腺素E_1治疗期间的总血流量分别增加到13.0±1.3和13.9±1.3毫升/分/100g(配对t检验，p&lt；0.01)。尽管tbf…未修饰前列腺素E_1组在给药后10分钟MUR降至8.0±1.0毫升/分/100克(配对t检验，p&lt；0.01)，脂微球-前列腺素E_1组维持在10毫升/分/100克以上。治疗结束后10min，PGE_1和Lipo-PGE_1治疗后血清PGE_1浓度分别为229±21和225±9 pg/ml(配对t检验，p&lt；0.01)，但分别下降到59±5和131±17 pg/ml(p&lt；0.01)。但LipoPGE1组的血清PGE1浓度显著高于未经修饰的PGE1组(非配对t检验，p&lt；0.01)。结论：LipoPGE1对猪胃管宏微循环有客观可测的改善作用，且作用时间延长。因此，输注前列腺素E_1脂微球可以增加吻合口的血流量，而且每天几次可能有利于预防吻合口瘘。较少

Introduction : Lrpo-prostaglandin El (PGEI) is a new preparation of PGE1 in which it is bound to lipids in order to slow PGE1 release and delay its rate of metabolism. We investigated the change of the blood flow on impaired microcirculation of the ischemic gastric tube in pigs after saline, unmodified PGE1 and lipo-PGE1 administration.Materials and Methods : The gastric tube was constructed using fifteen domestic pigs under general anesthesia, and saline, PGE1 and lipo-PGE1 were infused continuously at a rate of 0.05 μg/kg/min for 10 minutes. Tissue blood flow (TBF) and the serum PGE1 concentration were analyzed before administration, after administration for 10 minutes, and 10 minutes after the end of administration.Results : There were no obvious changes in TBF during the administration of saline. However, TBF during treatment with unmodified PGE1 and lipo-PGE1 was significantly increased to 13.0 ± 1.3 and 13.9 ± 1.3 ml/ min/ 100g, respectively (paired t-test ; p<0.01). Although TBF … More was significantly decreased to 8.0 ± 1.0 ml/ min/ 100g on 10 minutes after the end of unmodified PGE1 administration (paired t-test ; p<0.01), it was maintained over 10 ml/min/100g in lipo-PGE1 group. The serum PGE1 concentration during treatment with unmodified PGEI and lipo-PGE1 was significantly increased to 229 ± 21 and 225 ± 9 pg/ml (paired t-test ; p<0.01), however, it was significantly decreased to 59 ± 5 and 131 ± 17 pg/ml (paired t-test ; p<0.01), respectively, on 10 minutes after the end of administration. However, the serum PGE1 concentration in lipo-PGE1 group was significantly higher than that in with unmodified PGE1 group (unpaired t-test ; p<0.01).Conclusion : Lipo-PGE1 infusion leads to the objectively measurable improvement and the prolonged action in the macro-and microcirculation of the gastric tube in pigs. Therefore, treatment with lipo-PGE1 infusion can increase TBF at the anastomotic site, and it may be beneficial for preventing anastomotic leakage in boluses for a couple of times a day. Less