壳聚糖-羧甲基纤维素膜的制备及预防肠粘连的实验研究  

Preparation and evaluation of chitosan-carboxymethylcellulose membrane for prevention of postoperative intestinal adhesion:an experimental study

作　　者：肖海军[1] 侯春林[1] 官士兵[1] 刘亚平[1] 

机构地区：[1]第二军医大学长征医院骨科,上海200003

出　　处：《第二军医大学学报》2006年第7期755-759,共5页Academic Journal of Second Military Medical University

基　　金：国家自然科学基金(30170956)~~

摘　　要：目的:制备壳聚糖-羧甲基纤维素膜并探讨其预防肠粘连的效果。方法:将壳聚糖和羧甲基纤维素按1:1质量比混合,加入戊二醛、硫酸铝铵双交联,甘油增塑后烘干成膜;测定膜的拉伸强度及断裂伸长率并行电镜扫描。48只SD大鼠随机分成为3组(n=16),2组擦伤其回肠浆膜,制成肠粘连模型,于损伤部位分别包裹壳聚糖-羧甲基纤维素膜、壳聚糖膜;另一组不作处理作为对照组。术后第14天观察各组肠粘连情况。结果:膜拉伸强度约为20 MPa,断裂伸长率约为65%;扫描电镜(SEM)显示膜表面结构呈相互交错的纤维状,表面有不规则的孔状结构。壳聚糖-羧甲基纤维素膜组和壳聚糖膜组的粘连程度显著低于对照组(P<0.01)。光镜下见壳聚糖-羧甲基纤维素膜、壳聚糖膜组炎症反应轻微,纤维增生不显著;对照组粘连处纤维组织增生活跃,局部炎症反应明显。透射电镜下见壳聚糖-羧甲基纤维素膜组上皮细胞修复较壳聚糖膜组好,成纤维细胞增生不明显,对照组上皮细胞增生较慢,成纤维细胞分泌胶原功能活跃。结论:壳聚糖-羧甲基纤维素膜适于术中缝合需要,预防肠粘连效果显著,性能优于壳聚糖膜。Objective：To prepare and evaluate the effectiveness of chitosan-carboxymethylcellulose membrane in preventing postoperative intestinal adhesion. Methods： Chitosan-carboxymethylcellulose membrane was prepared with 1 ： 1 ratio of chitosan and carboxymethylcellulose. Glutaraldehyde and ammonium aluminium sulfate were used for cross-linkage, glycerin for enhancing plasticity; and then the product was dried. The membrane was observed with scanning electron microscopy （SEM） and its tensile strength and breaking elongation were measured. Forty-eight SD rats with ileum injury were randomly divided into A, B and C groups （n= 16）. During operation, the injury in group A was treated with chitosan-carboxymethylcellulose membrane, in group B with chitosan membrane, and in group C without treatment （control group）. The adhesion was observed on the 14th postoperative day. Results： The tensile strength of chitosan-carboxymethylcellulose membrane was 20 MPa and the breaking elongation was 65%. SEM showed that the morphology of the membrane had crossed fibroid structures and irregular pores. The severity of adhesion in group A and B was significantly lower than that in group C （P〈0.01）. Milder inflammatory changes and less fibrous proliferation were found in group A and B compared with those in group Co Epithelia rehabilitated better in group A than in group B, and the proliferation of fibroblast was not significant under electron microscope. In group C, epithelia rehabilitated slowly and fibroblasts excreted collagen actively. Conclusion： Chitosan-carboxymethylcellulose membrane is feasible for suturing during operation and is effective in reducing intestinal adhesion and it is superior to chitosan membrane.

关 键 词：壳聚糖 羧甲基纤维素 肠粘连 

分 类 号：R619[医药卫生—外科学]