Reliable anastomosis of esophageal reconstruction using laser Doppler flowmetry

简介：Lrpo-前列腺素E1（PGEI）是一种新的前列腺素E1制剂，其中它与脂质结合以减缓PGE 1的释放并延迟其代谢速率。材料与方法：15头家猪在全麻下建立胃管，分别以生理盐水、前列腺素E_1（PGE_1）和前列腺素E_1脂微脂制剂（lipo-PGE_1），以0.05 μg/kg/min的速度持续灌注10 min，观察生理盐水、PGE_1和lipo-PGE_1对缺血胃管微循环的影响。分别于给药前、给药后10 min、给药结束后10 min测定组织血流量（TBF）和血清前列腺素E1（PGE 1）浓度。然而，在用未修饰的PGE 1和脂质体-PGE 1治疗期间，TBF分别显著增加至13.0 ± 1.3和13.9 ± 1.3ml/ min/100 g（配对t检验; p<0.01）。虽然TBF 关于我们 未修饰的PGE_1给药结束后10分钟，PGE_1的血流量显著下降至8.0 ± 1.0ml/ min/100 g（配对t检验，p<0.01），而脂质体PGE_1组则维持在10 ml/min/100 g以上。在用未修饰的PGEI和脂质体-PGE 1治疗期间，血清PGE 1浓度显著增加至229 ± 21和225 ± 9 pg/ml（配对t检验; p<0.01），然而，在给药结束后10分钟，血清PGE 1浓度分别显著降低至59 ± 5和131 ± 17 pg/ml（配对t检验; p<0.01）。结论：Lipo-PGE_1输注对猪胃管宏观和微循环有明显改善作用，且作用时间延长。因此，用脂质体-PGE 1输注治疗可以增加吻合口部位的TBF，并且每天几次大剂量输注可能有利于预防吻合口瘘。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