TOTAL PARENTERAL BESLENMEDEN BAĞIMSIZ KISA BARSAK SENDROMU MODELİ (SIÇANLARDA DENEYSEL ÇALIŞMA)

Year 2013, Volume: 14 Issue: 3, 21 - 25, 01.12.2013

Gülnur Göllü Mine Şenyücel Aydın Yağmurlu

Abstract

AMAÇ: Çocuk yaş grubunda önemli mortalite ve bir morbidite olan kısa barsak sendromu (KBS); geniş barsak rezeksiyonu sonrası, kısalan barsak geçiş zamanı, yetersiz sindirim ve emilimi kapsar. KBS'de oluşan pek çok komplikasyonun hemen her zaman total parenteral beslenmeye (TPB) bağlı oluştuğu düşünülmektedir. Ancak TPB'den bağımsız da KBS komplikasyonları ortaya çıkabilmektedir. Bu çalışma ile TPB'den bağımsız oluşturulan KBS modeli oluşturulması planlandı.GEREÇ ve YÖNTEM: Ağırlıkları 180-220 g arasında değişen 37 adet erkek Wistar Albino cinsi sıçan, sham (n=16) ve kısa barsak sendromu (n=21) gruplarına ayrıldı. Sham grubunda ileoçekal valvin 15 cm. proksimalinden ileum transekte edildi ve rezeksiyon yapılmaksızın uç-uca anastomoz yapıldı. KBS grubunda ise, Treitz bağının 5 cm distali ile ileoçekal valvin 10 cm proksimali arasındaki ince barsaklar, mezenterik damarları ayrılarak, rezeke edildi ve jejenum ve ileum uç-uca tek tek anastomoz edildi. Deneklere eş besleme yapılarak günlük ve daha sonra yedi haftalık ağırlık takibi yapıldı.BULGULAR: KBS grubundaki deneklerin, sham grubuna göre birinci haftadan itibaren istatistiksel olarak anlamlı ağırlık kaybı yaşadıkları, zaman içinde ağırlık kazancı olsa bile hiçbir zaman sham grubundakileri yakalayamadıkları ancak yaşamlarını sürdürdükleri görüldü (*p < 0.05).SONUÇ: TPB'den bağımsız oluşturulan bu deneysel model ile sıçanlar yaşatılmakta ve TPB'nin etkileri olmadan karaciğer yetmezliği gibi KBS'nun fizyopatolojisi incelenebilecektir

Keywords

Kısa barsak sendromu, total parenteral besleme, ince barsak

A Model Of Short Bowel Syndrome Independent of Total Parenteral Nutrition (Experimental Study in Rats)

Abstract

OBJECTIVE: Short bowel syndrome (SBS) which causes significant morbidity and mortality in children includes short bowel transit time, inadequate digestion and absorption as a result of intensive intestine resections. Most of the complications in SBS ocur as a result of total parenteral nutrition (TPN). However there are some other complications independent of TPN, the aim is to compose a SBS model which is independent of TPN. MATERIAL and METHODS: Two groups of 37 male Wister Albino rats which have weights of 180-220 g were generated. Sham group contained 16 and SBS group contained 21 rats. In sham group, ileum was transected 15cm proximal to ileocecal valve and end-to-end anastomosis was performed without resection. In SBS group, small intestines between 5cm distal to Treitz ligament and 10cm proximal to ileocecal valve were resected after isolating mesenteric vessels, then end-to-end anastomosis was performed between jejunum and ileum. The rats were fed equally and their weight were followed daily for seven weeks. RESULTS: The rats in SBS group have statistically significant weight loss hence first week when compared to those in sham group. Although they had weight gain in time they couldn't catch up with those in sham group however they continued to survive (*p < 0.05). CONCLUSION: The rats survived in this TPN independent experimental model and it provides evaluation of SBS physiopathology such as liver failure without the effects of TPN.

Keywords

Short bowel syndrome, total parenteral nutrition, small intestine

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