先天性小肠闭锁病变肠管病理学研究
发布时间：2018-12-06 12:57
【摘要】：目的探讨先天性小肠闭锁病变肠管肠神经系统（ENS）、肠间质细胞（ICCs）病理变化特征，探讨小肠闭锁肠管远、近端神经介质组织学变化原因及手术切除肠管范围。 方法对小肠闭锁手术切除小肠标本19例及对照组5例小肠标本肠壁α-平滑肌肌动蛋白（α-SMA蛋白）、S-100蛋白、c-kit蛋白进行HE染色和免疫组化染色，观察闭锁两端肠壁平滑肌、肠神经系统(ENS)、肠间质细胞(ICCs)病理改变及其分布范围,并行统计学处理。 结果实验组闭锁近端8cm以内肠壁S-100、α-SMA和c-kit阳性表达率明显低于对照组；在闭锁近端11cm处各项指标与对照组缩小差异；在近端20cm、远端5cm处，，三者表达与对照组无明显差异。小肠闭锁肠壁两端平滑肌、肠神经系统和肠间质细胞均存在改变。闭锁近端肠管极度扩张、胎儿期闭锁肠管ENS发育延迟、人体胃肠道ENS及ICCs发育和成熟需要持续到出生后、闭锁近端肠管ICCs对c-kit的表达功能发生障碍等都有可能是闭锁两端肠管组织学存在异常的原因。 结论结合临床术后表现，以尽可能切除扩张、缺血坏死明显的肠段为原则，切除闭锁近端肠管11cm以上，切除闭锁远端肠管5cm,可视为手术的合理切除范围。
[Abstract]:Objective to investigate the pathological changes of intestinal interstitial cells (ICCs) in enteric nervous system (ENS),) of congenital intestinal atresia, and to explore the histological changes of distal and proximal neurotransmitters in intestinal atresia and the extent of surgical excision. Methods the intestinal wall 伪 -smooth muscle actin (伪-SMA protein), S-100 protein and c-kit protein were stained by HE and immunohistochemical staining in 19 cases of intestinal atresia and 5 cases of control group. The pathological changes and distribution of (ICCs) in (ENS), intestinal interstitial cells of atresia were observed. Results the positive expression rates of S-100, 伪 SMA and c-kit in the proximal 8cm of the experimental group were significantly lower than those in the control group. At the proximal 20 cm and distal 5cm, there was no significant difference between the three groups. The smooth muscle at both ends of intestinal atresia, intestinal nervous system and interstitial cells were all changed. At the proximal end of atresia, the development of ENS is delayed, and the development and maturation of ENS and ICCs in the gastrointestinal tract of human body need to continue after birth. The dysfunction of ICCs expression of c-kit in proximal atresia may be the cause of abnormal histology of atresia. Conclusion combined with clinical manifestations, the principle of resection of intestinal segments with dilatation and ischemic necrosis as far as possible can be regarded as the reasonable range of resection. The resection of proximal atresia above 11cm and resection of distal atresia can be regarded as the reasonable range of resection.
【学位授予单位】：重庆医科大学
【学位级别】：硕士
【学位授予年份】：2012
【分类号】：R726.5
本文编号：2366059
[Abstract]:Objective to investigate the pathological changes of intestinal interstitial cells (ICCs) in enteric nervous system (ENS),) of congenital intestinal atresia, and to explore the histological changes of distal and proximal neurotransmitters in intestinal atresia and the extent of surgical excision. Methods the intestinal wall 伪 -smooth muscle actin (伪-SMA protein), S-100 protein and c-kit protein were stained by HE and immunohistochemical staining in 19 cases of intestinal atresia and 5 cases of control group. The pathological changes and distribution of (ICCs) in (ENS), intestinal interstitial cells of atresia were observed. Results the positive expression rates of S-100, 伪 SMA and c-kit in the proximal 8cm of the experimental group were significantly lower than those in the control group. At the proximal 20 cm and distal 5cm, there was no significant difference between the three groups. The smooth muscle at both ends of intestinal atresia, intestinal nervous system and interstitial cells were all changed. At the proximal end of atresia, the development of ENS is delayed, and the development and maturation of ENS and ICCs in the gastrointestinal tract of human body need to continue after birth. The dysfunction of ICCs expression of c-kit in proximal atresia may be the cause of abnormal histology of atresia. Conclusion combined with clinical manifestations, the principle of resection of intestinal segments with dilatation and ischemic necrosis as far as possible can be regarded as the reasonable range of resection. The resection of proximal atresia above 11cm and resection of distal atresia can be regarded as the reasonable range of resection.
【学位授予单位】：重庆医科大学
【学位级别】：硕士
【学位授予年份】：2012
【分类号】：R726.5
【参考文献】
相关期刊论文 前1条
1 付军,王练英,李正;对先天性小肠闭锁手术切除肠管连续切片的组织学观察[J];辽宁医学杂志;1998年06期
本文编号：2366059
本文链接：https://www.wllwen.com/yixuelunwen/eklw/2366059.html
最近更新
教材专著
