Yusuf PEKER, Fahrettin YILDIZ, NAZİF ZEYBEK, Türker ÇETİN, Levent KENAR, MUHİTTİN ABDULKADİR SERDAR, Bülent KURT, Turgut TUFAN

Correlation of biochemical markers with histopathological findings in experimental strangulated hernia

Amaç: Bu çalışmada obstrüksiyonun neden olduğu intestinal iskeminin tespiti için, hematolojik parametreler ve biyokimyasal göstergelerdeki değişikliklerin kullanılıp kullanılamayacağı araştırıldı. Gereçler ve Yöntemler: Beş gruba bölünen 40 adet sıçana şu yöntemler uygulandı: Grup 1'deki sıçanlara sadece laparotomi yapıldı, diğer strangüle herni gruplarına ise cerrahi olarak strangüle intestinal obstrüksiyon oluşturuldu. Doku ve kan örnekleri sırasıyla 30. dakikada (grup 2), 2. saatte (grup 3), 4. saatte (grup 4) ve 6. saatte (grup 5) alındı ve daha sonra LDH, CPK, ALP, AST, ALT, D-dimer seviyeleri, tam kan sayımı ölçüldü ve histopatolojik inceleme yapıldı. Bulgular: Eşlik eden fokal mukozal nekroz histolojik bulgularla strangüle intestinal iskemi grubunda 2. saatte gözlendi. Serum D-dimer, ALT, ALP, CPK seviyeleri ve nötrofil sayımı 2. saatte arttı ve istatistiksel olarak anlamlıydı. Sonuç: Fıtık hastalarında redüksiyon sonrasında artmış serum D-dimer, ALT, ALP, CPK seviyelerive nötrofil sayımı barsak iskemisinin bir göstergesi olabilir. Bununla birlikte laparatomi gereksiniminin göstergesi olabilecek testlerin potansiyel faydalarının değerlendirilmesi için daha geniş prospektif klinik çalışmalara ihtiyaç vardır.

Deneysel boğulmuş fıtık modelinde biyokimyasal ve histopatolojik bulguların karşılaştırılması

Objectives: This study was planned to evaluate whether possible changes in the hematological parameters and the biochemical markers can be used to detect obstruction-induced (strangulated) intestinal ischemia. Materials and Methods: Forty rats divided into five groups underwent the following procedures: Group 1 rats were treated with only laparotomy (sham-operated controls). To the strangulated hernia groups surgical induction of strangulated intestinal obstruction was performed. Tissue and blood samples were taken at 30 minutes (group 2), 2nd hour (group 3), 4th hour (group 4) and 6th hour (group 5) respectively, and then LDH, CPK, ALP, AST, ALT, D-dimer levels and blood cells counts were measured and histopathological examination was done. Results: Focal mucosal necrosis accompanied was confirmed by histological findings in the strangulated intestinal ischemia group after second hour. Serum D-dimer, ALT, ALP, CPK levels and neutrophil count became elevated at second hour, which was statistically significant. Conclusion: In patients with hernia, after reduction of the intestinal hernia, raised levels of serum D-dimer, ALT, ALP, CPK levels and neutrophil count may indicate the presence of a bowel ischemia. However, more comprehensive clinical studies are required to evaluate the potential survival benefit by using the laboratory tests as a marker and/or a useful diagnostic tool of the need for laparotomy.

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