急性粘连性小肠梗阻小肠形态功能改变

M. Gulzoda, B. I. Safarov, K. R. Ruziboyzoda, K. K. Kobilov
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摘要

目的:探讨急性粘连性小肠梗阻小肠黏膜形态功能变化特点。材料和方法。本文对50例急性粘连性小肠梗阻患者中的20例进行了小肠粘膜形态学和功能变化的综合研究。患者接受小肠切除术和粘膜活检,然后对活检标本进行病理形态学和生化检查。研究结果表明,急性粘连性小肠梗阻伴广泛(多发)粘连患者的小肠黏膜病理形态学改变较伴局限性(单一)粘连患者更为明显。在多发性(广泛)粘连的急性粘连性小肠梗阻患者的小肠黏膜生化参数研究中,与单一(有限)粘连患者组相比,脂质过氧化和促炎细胞因子显著且临界增加,抗氧化保护能力下降。小肠黏膜的血清素浓度也有所下降。在这些患者中存在单一(有限)粘连时,它降低到0,50±0,3个单位,在多个(常见)粘连的患者中-降低到0,20±0,2 arb。units.Conclusion。小肠黏膜形态功能改变的严重程度与粘连过程发展的严重程度和急性粘连性小肠梗阻直接相关。
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Morphofunctional changes in the small intestine in acute adhesive small bowel obstruction
Aim: To study the features of morpho-functional changes in the small intestine mucosa in acute adhesive small bowel obstruction.Material and methods. The results of a comprehensive study of morphological and functional changes in the small intestine’s mucous membrane in 20 patients out of 50 with acute adhesive small intestinal obstruction were analyzed. Patients underwent resection of the small intestine with a biopsy from the mucous membrane, followed by a pathomorphological and biochemical examination of biopsy specimens.Results. The study results show that more pronounced pathomorphological changes in the mucous membrane of the small intestine were observed in patients with acute adhesive small intestinal obstruction with widespread (multiple) adhesions compared with limited (single) adhesions. In the study of biochemical parameters in the small intestine mucosa in patients with acute adhesive small intestinal obstruction with the presence of multiple (widespread) adhesions, there was a significant and critical increase in lipid peroxidation and proinflammatory cytokines, a decrease in antioxidant protection compared to the patient group with the presence of single (limited) adhesions. There was also a decrease in the concentration of serotonin in the mucosa of the small intestine. In the presence of single (limited) adhesions in these patients, it decreases to 0,50±0,3 units, and in patients with multiple (common) adhesions - to 0,20±0,2 arb. units.Conclusion. The severity of morpho-functional changes in the mucosa of the small intestine directly correlates with the severity of the development of the adhesive process and acute adhesive small bowel obstruction. 
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