Reliable anastomosis of esophageal reconstruction using laser Doppler flowmetry

简介：Lrpo-prostaglandin El （PGEI）是一种新的PGE1制剂，它与脂质结合，以减缓PGE1的释放，延缓其代谢速率。我们研究了生理盐水、未修饰PGE1和脂质PGE1给药后缺血胃管微循环受损的血流变化。材料与方法：15头家猪在全麻状态下构建胃管，以0.05 μg/kg/min的速率连续输注生理盐水、PGE1和脂质体-PGE1，持续10分钟。分析给药前、给药后10分钟、给药结束后10分钟组织血流量（TBF）和血清PGE1浓度。结果：生理盐水对TBF无明显影响。而未修饰PGE1和脂质PGE1治疗时TBF分别显著增加至13.0±1.3和13.9±1.3 ml/ min/ 100g（配对t检验；p<0.01）。PGE1给药结束后10分钟，TBF . More显著降低至8.0±1.0 ml/min/100g（配对t检验，p<0.01），脂质PGE1组TBF . More维持在10 ml/min/100g以上。未加修饰的PGEI和脂质PGE1治疗组血清PGE1浓度显著升高至229±21和225±9 pg/ml（配对t检验，p<0.01），但在给药结束后10分钟，血清PGE1浓度分别显著降低至59±5和131±17 pg/ml（配对t检验，p<0.01）。脂质PGE1组血清PGE1浓度显著高于未修饰PGE1组（未配对t检验；p<0.01）。结论：lipop - pge1输注对猪胃管大循环和微循环有明显的改善作用和延长作用。因此，脂质pge1输注治疗可增加吻合口TBF，可能有利于防止吻合口漏，每天注射几次。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