Koroziv özofajite sekonder darlıklar extractum cepae heparin ve allantoin jel ile önlenebilir mi?
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Date
2011
Authors
Mercan, Mehmet Hilmi
Journal Title
Journal ISSN
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Publisher
Uludağ Üniversitesi
Abstract
Koroziv maddelerin içimi çocuk yaş grubunda sıkça rastlanan, önlenebilir bir travmadır. Travmanın uzun dönemde en önemli morbidite ve mortalite sebebi özofagus striktürüdür. Çalışmamızda özofagus hasarı sonrası iyileşme aşamasında olası striktürlerin önlenmesi amaçlanmıştır.Çalışmada deney modeli olarak Şentürk ve ark. tarafından tanımlanan koroziv özofagus modeli 30 adet Wistar albino sıçan üzerinde uygulandı. Özofagus hasarı %10 NaOH, %1 monoetanolamin karışımının %70'lik çözeltisi ile oluşturuldu. Koroziv madde uygulanan denekler 3 gruba ayrıldı. Ayrıca hasar oluşturulmayan 6 denekle sham grubu oluşturuldu. Kontrol grubundaki deneklere koroziv madde uygulanması sonrası tedavi verilmezken oral tedavi grubuna extractum cepae, heparin ve allantoin (CHA) karışımından oluşan contractubex® jel oral olarak verildi. Kateterle tedavi grubuna jel kateterle özofagus lümenine verildi. Sham grubundaki denekler günde 1 kez feeding sonda ile kateterize edildi. Sonuçlar histopatolojik veriler ve deneklerin canlı ağırlık artışları ile değerlendirildi.Gruplar çalışma sonunda canlı ağırlık artışı yönünden karşılatırıldığında tedavi gruplarının ağırlık artışının kontrol grubuna göre anlamlı düzeyde arttığı saptandı (P<0,001). Histolojik değerlendirmede epitelyal-müsküler atrofi, submukozal kollajen depozisyonu, submukozal ödemin eşlik ettiği mukozal kıvrımlar, submukozal kollajen depozisyonunun eşlik ettiği mukozal kıvrımlar, submukozal kollajen depozisyonunun eşlik ettiği striktürel oluşumlar ve intra müsküler kollajen depozisyonu parametreleri kullanıldı. Epitelyal ve müsküler atrofi açısından anlamlı fark saptandı (P=0,005). Submukozal kollajen depozitleri değerlendirildiğinde tedavi gruplarında saptanan lezyonların daha küçük boyutlu olduğu görüldü ancak anlamlı fark saptanmadı. Ayrıca uygulama yolları arasında da anlamlı fark saptanmadı.CHA deneklerin canlı ağırlık artışında ve özofagus lümen açıklığının korunmasında etkilidir. Özofagus striktürlerinin önlenmesinde kullanılabilir ancak oral uygulanabilir formunun hazırlanmasına ihtiyaç duyulmaktadır.
Corrosive esophageal burns are preventable trauma, frequently encountered in the age group of children. The most important cause of morbidity and mortality in long-term follow up in this trauma is esophageal stricture. We aimed to prevention of esophageal strictures during healing after corrosive substance intake.In this study, the corrosive esophagus experimental model that defined by Senturk et al was used with 30 wistar albino rats. Esophageal injury created by 70% solution of 10% NaOH and 1% mono ethanol amine. The subjects divided four groups; control (n:10), oral treatment group (n:10), treatment with catheter group (n:10) and sham group (n:6). The sham group was not injured by corrosive. Contractubex® gel that contains Extractum cepa, heparin and allantoin (CHA) was given with nutrients daily for oral treatment group and given with feeding tube for catheter treatment group for 21 days. Sham group subjects catheterized daily with feeding tube. The results were evaluated with histopathologic data and the subjects' body weight increases.The groups were compared in terms of weight gain at the and of the study. The treatment groups weight gain were significantly higher than the control group (P <0.001). Histologic evaluation was performed by epithelyal and muscular atrophy, mucosal folds with submucosal collagen deposition, mucosal folds with submucosal edema, structural formations with submucosal collagen deposition and intra-muscular collagen deposition. There was significant difference in epithelial and muscular atrophy between control and treatment groups (P = 0.005). Submucosal collagen deposition was evaluated, treated groups had smaller lesions, but there was no significant difference. There was also no significant difference between routes of administration.The CHA is effective in the protection of esophageal lumen patency, and subjects' body weight increase. CHA can be applied in the prevention of esophageal strictures but oral form is not available and it must be prepared.
Corrosive esophageal burns are preventable trauma, frequently encountered in the age group of children. The most important cause of morbidity and mortality in long-term follow up in this trauma is esophageal stricture. We aimed to prevention of esophageal strictures during healing after corrosive substance intake.In this study, the corrosive esophagus experimental model that defined by Senturk et al was used with 30 wistar albino rats. Esophageal injury created by 70% solution of 10% NaOH and 1% mono ethanol amine. The subjects divided four groups; control (n:10), oral treatment group (n:10), treatment with catheter group (n:10) and sham group (n:6). The sham group was not injured by corrosive. Contractubex® gel that contains Extractum cepa, heparin and allantoin (CHA) was given with nutrients daily for oral treatment group and given with feeding tube for catheter treatment group for 21 days. Sham group subjects catheterized daily with feeding tube. The results were evaluated with histopathologic data and the subjects' body weight increases.The groups were compared in terms of weight gain at the and of the study. The treatment groups weight gain were significantly higher than the control group (P <0.001). Histologic evaluation was performed by epithelyal and muscular atrophy, mucosal folds with submucosal collagen deposition, mucosal folds with submucosal edema, structural formations with submucosal collagen deposition and intra-muscular collagen deposition. There was significant difference in epithelial and muscular atrophy between control and treatment groups (P = 0.005). Submucosal collagen deposition was evaluated, treated groups had smaller lesions, but there was no significant difference. There was also no significant difference between routes of administration.The CHA is effective in the protection of esophageal lumen patency, and subjects' body weight increase. CHA can be applied in the prevention of esophageal strictures but oral form is not available and it must be prepared.
Description
Keywords
Koroziv özofajit, Deneysel model, Contractubex®, Corrosive esophagitis, Experimental model
Citation
Mercan, M. H. (2011). Koroziv özofajite sekonder darlıklar extractum cepae heparin ve allantoin jel ile önlenebilir mi?. Yayınlanmamış uzmanlık tezi. Uludağ Üniversitesi Tıp Fakültesi.