淀粉型可吸收多聚糖止血粉预防大鼠术后肠粘连  

Preventive effect of starch-derived absorbable polysaccharide hemostat on postoperative intestinal adhesion

作　　者：牛雯[1] 刘毅[1] 李志超[1] 王艳霞[1] 刘曼玲[1] 李艳[2] 董海莹[1] 

机构地区：[1]解放军第四军医大学基础部病理与病理生理学教研室,陕西省西安市710032 [2]解放军第四军医大学护理系,陕西省西安市710032

出　　处：《中国组织工程研究与临床康复》2009年第12期2287-2290,共4页Journal of Clinical Rehabilitative Tissue Engineering Research

基　　金：国家自然科学基金面上项目(30700965)~~

摘　　要：背景:淀粉型可吸收多聚糖止血粉是美国新推出的可吸收型止血材料,因其具有良好的止血作用且能被体内完全降解吸收目前已用于临床。目的:观察来源于淀粉的可吸收多聚糖止血粉对术后肠粘连的预防作用。设计、时间及地点:对比观察实验,于2007-06/2008-06在解放军第四军医大学病理生理学教研室完成。材料:两种可吸收多聚糖止血粉:PerClotTM由美国Starch Medical Inc公司提供、AristaTMAH由美国Medafor Inc.公司提供。透明质酸钠由上海建华精细生物制品有限公司提供。方法:48只SD雄性大鼠建立肠粘连模型,随机分为4组,每组12只,其中PerClotTM、AristaTMAH和透明质酸钠组分别以相同剂量(1g)药物完全覆盖创面,对照组不给予任何药物。14d后剖腹取材。主要观察指标:①大体观察动物伤口和腹腔感染情况,比较各组药物体内残留情况。②半定量的分级评定法观察腹腔粘连情况。③组织病理学观察浆膜创面修复情况。结果:AristaTMAH、PerClotTM和透明质酸钠组腹腔粘连程度明显低于对照组(P<0.05),但3者之间抗粘连效果差异无显著性意义(P>0.05)。PerClotTM组、AristaTMAH组术后腹腔中均无多聚糖膜残留,但透明质酸钠组腹腔内有大量积液。组织病理学结果显示对照组肠管浆膜面有明显的炎症细胞浸润和纤维组织增生,而AristaTMAH、PerClotTM和透明质酸钠组病理改变明显轻于对照组。结论:两种来源于淀粉的可吸收多聚糖止血粉与透明质酸钠均有预防术后肠粘连作用。BACKGROUND： Starch-derived absorbable polysaccharide hemostat （SAPH） is a new material discovered in the USA, and recently it is frequently used in clinic because of great hemostasis and complete degradation. OBJECTIVE： To observe the effect of SAPH on preventing postoperative intestinal adhesion. DESIGN, TIME AND SETTING： A contrast study was performed at Department of Pathophysiology, the Fourth Military Medical University of Chinese PLA between June 2007 and June 2008. MATERIALS： Two types of SAPH were used in this study, including polysaccharide hemostatic system （PerCtotTM） provided by Starch Medical Inc, USA and absorbable polysaccharide hemosphere （AristaTMAH） provided by Medafor Inc USA. Sodium hyaluronate was provided by Shanghai Jianhua Fine Biological Products Co., Ltd. METHODS： A total of 48 male Sprague-Dawley rats were randomly divided into four groups, PerCIotTM （1 g） group, AristaTMAH （1 g） group, sodium hyalurate （1 g） group, and control group （without any drug）. The traumatic intestinal adhesive model was made in the caecums of the rats. After two weeks of the treatments, animals were killed. MAIN OUTCOME MEASURES： Infection of abdominal cavities was generally observed and drug residual was compared in the four groups. Adhesive severity was semi-graded. The traumatic caecums were resected for histopathological examination. RESULTS： （1） Adhesion severity in AristaTMAH group, PerCIotTM group, and sodium hyalurate group was significantly lower than control group （P 〈 0.05）, but there were no difference among the former three groups. Saccharan membrane residual was not observed in PerCIotTM group and AristaTMAH group, but a large amount of seroperitoneum of the rats was observed in the sodium hyalurate group. Histopathological examination indicated that there were remarkably inflammatory cell infiltrating and fibrous tissue hyperplasia in the control group, and the pathological changes in AristaTM AH group, PerClotTM group and sodium hyalurate grou

关 键 词：来源于淀粉的可吸收多聚糖止血粉 PerClotTM AristaTM AH 透明质酸钠 肠粘连 

分 类 号：R318[医药卫生—生物医学工程]