卡巴胆碱预防术后腹腔粘连的实验研究  

Experimental Study on Preventive Effect of Carbachol on Postoperative Intra-Abdominal Adhesions

作　　者：田易军[1] 胡森[1] 包呈梅[1] 王磊[1] 吴静[1] 金芳[1] 

机构地区：[1]解放军总医院第一附属医院全军烧伤研究所休克与多器官功能障碍实验室,北京100037

出　　处：《中国普外基础与临床杂志》2008年第6期435-439,共5页Chinese Journal of Bases and Clinics In General Surgery

基　　金：军队医药卫生"十一五"专项课题(编号:06Z055)~~

摘　　要：目的观察拟胆碱药卡巴胆碱预防腹腔粘连的作用。方法44只雄性Wistar大鼠按完全随机法分为假手术组(n=12)、手术对照组(n=16)及卡巴胆碱组(n=16,卡巴胆碱50μg/kg),后2组采用开腹后无菌干纱布摩擦大鼠盲肠蚓突部,钳夹和刮伤腹壁法制作大鼠腹腔粘连动物模型。各组于术后第7d和第14d各处死一半动物,参考Phillips5级分类法并结合本模型特点进行大体粘连程度分级评分;取粘连组织切片行HE染色观察粘连组织病理变化,免疫组化法观察粘连组织Ⅰ型胶原含量变化,并进行图像分析。结果卡巴胆碱组第7d与第14d大体粘连程度评分均明显低于手术对照组,差异有统计学意义(P<0.01);HE染色显示卡巴胆碱组比之手术对照组炎症反应轻,偶见增生纤维结缔组织;Ⅰ型胶原含量卡巴胆碱组第7d与第14d均明显低于手术对照组(P<0.01);各组内第7d与第14d比较,腹腔大体粘连程度评分和Ⅰ型胶原含量差异无统计学意义(P>0.05)。结论拟胆碱药卡巴胆碱能显著预防大鼠腹腔粘连形成,降低粘连程度。Objective To investigate the preventive effect of carbachol on the formation of postoperative intraabdominal adhesion. Methods Forty-four Wistar rats were randomly divided into sham operation group （SO group, n= 12）, operation group （n= 16） and carbachol treated group （carbachol group, n= 16, carbachol 50 ug/kg）. Animal model of abdominal adhesion was established by rubbing the procussus vermiformis of cecum with dry sterile gauze, and by clamping and scuffing abdominal wall. Half of rats were separately killed on day 7 and day 14 after surgery, respectively. The degree of adhesion was evaluated according to Phillips 5-scale grade and the feature of this model. The histopathological changes of adhesive tissues were observed and the content of collagen type I in the tissues was detected by immunohistochemistry. Results The scores of intra-abdominal adhesion were significantly lower in the carbachol group than those in operation group both on 7 d and 14 d （P〈0.01）. Mild inflammatory changes and less fibrous proliferation were observed in carbachol group microscopically. The contents of collagen type I detected by immunohistochemistry were significantly lower in the carbachol group than those in operation group both on 7 d and 14 d （P〈0.01）. There was no significant difference of the score of abdominal adhesion and content of collagen type Ⅰ in the same group between 7 d and 14 d （P〉0.05）. Conclusion Carbachol may take a significant role in the prevention of postoperative abdominal adhesion in rat.

关 键 词：卡巴胆碱 腹腔粘连 动物模型 Ⅰ型胶原 

分 类 号：R619[医药卫生—外科学]