【摘要】：目的探討先天性小腸閉鎖病變腸管腸神經(jīng)系統(tǒng)（ENS）、腸間質(zhì)細胞（ICCs）病理變化特征，探討小腸閉鎖腸管遠、近端神經(jīng)介質(zhì)組織學變化原因及手術(shù)切除腸管范圍。 方法對小腸閉鎖手術(shù)切除小腸標本19例及對照組5例小腸標本腸壁α-平滑肌肌動蛋白（α-SMA蛋白）、S-100蛋白、c-kit蛋白進行HE染色和免疫組化染色，觀察閉鎖兩端腸壁平滑肌、腸神經(jīng)系統(tǒng)(ENS)、腸間質(zhì)細胞(ICCs)病理改變及其分布范圍,并行統(tǒng)計學處理。 結(jié)果實驗組閉鎖近端8cm以內(nèi)腸壁S-100、α-SMA和c-kit陽性表達率明顯低于對照組；在閉鎖近端11cm處各項指標與對照組縮小差異；在近端20cm、遠端5cm處，，三者表達與對照組無明顯差異。小腸閉鎖腸壁兩端平滑肌、腸神經(jīng)系統(tǒng)和腸間質(zhì)細胞均存在改變。閉鎖近端腸管極度擴張、胎兒期閉鎖腸管ENS發(fā)育延遲、人體胃腸道ENS及ICCs發(fā)育和成熟需要持續(xù)到出生后、閉鎖近端腸管ICCs對c-kit的表達功能發(fā)生障礙等都有可能是閉鎖兩端腸管組織學存在異常的原因。 結(jié)論結(jié)合臨床術(shù)后表現(xiàn)，以盡可能切除擴張、缺血壞死明顯的腸段為原則，切除閉鎖近端腸管11cm以上，切除閉鎖遠端腸管5cm,可視為手術(shù)的合理切除范圍。
[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 偽 -smooth muscle actin (偽-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, 偽 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.
【學位授予單位】：重慶醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2012
【分類號】：R726.5

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相關(guān)期刊論文 前1條

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