METHODS: By use of LDFS, intestinal microperfusion was quantified as tissue oxygen saturation (tSo2), hemoglobin (tHB), and blood flow (tBF) in cases with large colon volvulus and small colon strangulations undergoing colic surgery (n = 17). Intestinal biopsies were taken from the pelvic flexure in all large colon cases and in small colon cases that underwent intraoperative euthanasia. Measurements were compared between survivors and nonsurvivors, and the correlation between LDFS and (immuno)histology was tested (P < .05).
RESULTS: The tSo2 and tBF were clearly lower and tHB was higher than previously reported in healthy horses. Following correction of the lesion, pelvic flexure tBF was significantly lower than that of the left ventral colon. Prior to correction of the lesion, microperfusion did not differ between survivors and nonsurvivors, but following release of the strangulation the survivors had a significantly higher tSo2 and tBF compared to the nonsurvivors. There was a negative correlation between tBF and interstitium-to-crypt ratio and a positive correlation between tHB and the histological hemorrhage score. There were no significant correlations between LDFS measurements and inflammatory cell counts or hypoxia-inducible factor-1α immunoreactivity.
CONCLUSIONS: Large intestinal microperfusion was decreased in nonsurvivors compared to survivors and was correlated with histological injury, suggesting that LDFS has the potential to predict tissue injury and postoperative survival.
CONCLUSIONS: The use of LDFS as an ancillary diagnostic aid may improve intraoperative viability assessment during colic surgery.
方法:通过使用LDFS,肠道微灌注被量化为组织氧饱和度(tSo2),血红蛋白(tHB),在接受绞痛手术的大结肠扭转和小结肠绞窄的病例中(n=17)和血流量(tBF)。在所有大结肠病例和接受术中安乐死的小结肠病例中,均从骨盆弯曲处进行肠活检。测量结果在幸存者和非幸存者之间进行比较,LDFS与(免疫)组织学之间的相关性进行了测试(P<0.05)。
结果:tSo2和tBF明显低于健康马匹,tHB高于先前报道的。病灶矫正后,盆屈tBF明显低于左侧腹侧结肠。在病灶矫正之前,微灌注在幸存者和非幸存者之间没有差异,但在释放绞刑后,与非幸存者相比,幸存者的tSo2和tBF显著较高.tBF与间质与隐窝比率之间呈负相关,而tHB与组织学出血评分之间呈正相关。LDFS测量值与炎症细胞计数或缺氧诱导因子-1α免疫反应性之间没有显着相关性。
结论:与幸存者相比,非幸存者的大肠微灌注减少,并且与组织学损伤相关,表明LDFS有可能预测组织损伤和术后生存率。
结论:使用LDFS作为辅助诊断辅助手段可以改善绞痛手术期间的术中可行性评估。