A Study On The Effect Of Heparin On The Recovery Of Incarcerated Intestine By Using Rat Incarcerated Hernia Model

[Background and purpose]: TAPP can observe the conditions of intra-abdominal organs under laparoscopic visualization,and is more advantageous in judging the activity of bowel incarceration.With the gradual application of clinical application of TAPP,it is possible to directly observe the activity of the intestine at the same time as the repair of the primary patch.This makes the observation of the recovery of the intestinal tract activity closer to the end of necrosis more intuitive,and it is timely to repair the incarcerated hernia.Whether necrotic bowel can retain new opportunities.Heparin is widely used as a common anticoagulant in clinical practice,especially in the prevention or treatment of venous thromboembolic diseases;at the same time,heparin has an anti-inflammatory effect;and it has an antioxidant free radical effect.Based on the above effects of heparin,and the incarceration of intestinal necrosis is mainly due to intestinal blood flow disorders,local microcirculation of the intestinal microcirculation caused by micro-thrombosis.Therefore,it is envisaged that in the case of observing intestine that is difficult to judge after incarceration,if heparin is used instead of textbook procaine,there may be more satisfactory recovery of bowel activity.So that the vitality of the suspected intestine can be retained,incarcerated patients with incarcerated hernia repair patch tension repair provides the conditions,and reduce the future occurrence of patch infections and other complications.In order to verify this hypothesis,this experiment intends to investigate the effect of heparin on accelerating the recovery of incarceration of intestine by using the rat incarcerated indwelling model.The experimental results can be converted into clinical use.[Methods] :1.Determine the relationship between bowel incarceration time and intestinal activity:Eighteen healthy male Sprague Dawley rats(body weight 200±20g)were selected to make an abdominal wall incarcerated hernia animal model.1.1 According to the increase of intestinal incarceration time,the models were divided into 3 groups,3 rats in each group,and the incarceration time was from 2h.Rats were sacrificed as time nodes at 2h,4h and 6h respectively,according to different time nodes.Necrotic bowel morphology and histological observation,local and systemic observations were performed to compare the differences in the degree of intestinal necrosis between the groups.1.2 According to the above time points,select the time period before the myometrial necrosis of the intestine,and divide each group into three groups at a time point of 0.5 hours,3 rats in each group.Observe the postoperative survival of the rats,local wound infection,inflammation,abdominal signs(intestinal obstruction,peritonitis)and systemic manifestations(shock,death);observation of intestinal necrosis: intestinal wall color and morphology;intestinal wall tension and peristalsis Ability,contraction response to external stimuli;corresponding mesenteric terminal arterial pulse condition.The rats were sacrificed and paraffin sections of the intestine were sectioned and HE stained for microscopic injury scores of strangulated intesti-nal segment.Some of the intestinal citrates were fixed and then fused with electron microscope,combined with light microscopy results,electron microscopy results,intestinal tract morphology,staining,Peristaltic conditions determine the best incarceration time.2.Determine the concentration of heparin: Select 12 healthy male SD rats(200±20g body weight)into four groups to make an abdominal wall incarcerated animal model.The heparin concentration gradient was set according to the amount of heparin used for liver transplantation in rats,and the intestinal obstruction was relieved at the best incarceration time.Different concentrations of heparin were used: 12.5u/100 g,25u/100 g,37.5 u/100 g,50 u/100 g were sprayed on the surface of the inactivated intestine in three groups respectively.After 1 hour,the activity of the intestine was recovered and the complications were observed.The rats were killed and the intestinal and milk spots were fixed with anhydrous acetaldehyde,embedded in paraffin,and sliced.Dyeing,choose the best concentration to use.3.Comparing the short-term effects of heparin,lidocaine hydrochloride,and procaine on bowel activity: Select 24 healthy male SD rats(200±20 g body weight)and divide them into three groups to create an animal model of abdominal incarcerated incarceration.Time to relieve intestinal obstruction,heparin,lidocaine hydrochloride,procaine were sprayed on the surface of the three groups of inactivated bowel,sutured layer by layer,1.5 hours after the hospital path incision abdomen,observed changes in intestinal activity,and the rats were sacrificed to the intestine And milk spots fixed with anhydrous acetaldehyde paraffin embedding,slicing,staining.The effects of heparin,lidocaine hydrochloride,and procaine on intestinal activity were compared based on changes in the naked eye and light microscopy.4.The long-term effects of heparin and procaine on bowel activity were compared: 24 healthy male Sprague-Dawley rats(weighing 200±20g)were selected and divided into two groups to make a model of abdominal incarcerated incarceration.At the best incarceration time,intestinal obstruction was relieved,intraocular hemorrhage was taken,and heparin and procaine were sprayed on the surface of the inactivated bowel,and sutured layer by layer.Each group was divided into four groups and the abdomen was incised along the original route at 3h,6h,12 h,and 24 h afterwards.Changes in the activity of the intestine were observed.The blood was taken from the eyes and the rats were sacrificed.The intestine was fixed with anhydrous acetaldehyde and paraffin-embedded.Buried,sliced,stained.Internal hemorrhoids were stored at-80 degrees Celsius,and ELISA was used to measure MDA and endotoxin.The effects of heparin,lidocaine hydrochloride,and procaine on intestinal activity were evaluated based on changes in the naked eye,changes in light microscopy,and MDA content and endotoxin levels.[Result ] 1.Incarcerated intestine in the 2-4h intestinal myometrium necrosis,4-6 hours after the whole intestinal necrosis;2.After 1.5h of incarceration with lidocaine,procaine and heparin,the effect of heparin group on intestinal activity was more effective than that of lidocaine and procaine group.Procaine was more effective than lidocaine group;3.The effect of heparin group on intestinal activity was more effective than procaine group after 2.5h of incarceration with procaine and heparin for 3-24h;serum MDA procaine group was elevated and heparin group was decreased.4.When using heparin,attention should be paid to the recent complications such as incision and subcutaneous oozing;the risk of intestinal obstruction after incarceration of intestine should be maintained.[Conclusion]1.The rat incarcerated hernia model was used to observe the effect of drugs on intestinal activity.The best incarceration time was 2.5 hours.2.Lidocaine,procaine,and heparin were used for 1.5h.The effect of heparin group on intestinal activity was more effective than that of lidocaine and procaine under the condition of naked eye and light microscope,and procaine was more effective than lidocaine group.3.Heparin has a significant effect on intestinal activity recovery of incarcerated intestine.4.the color change of the breast spots was most obvious when the intestinal tube was activated by naked eyes.5.after incarcerated intestinal tube injection,heparin should pay attention to postoperative complications subcutaneous hematoma.Postoperative pressure bandage can reduce this complication to a certain extent.