脱乙酰壳多糖预防术后肠粘连40例疗效及安全性评价  

Clinical Effect and Safety of Chitosan for Preventing Postoperative Intestinal Adhesion in 40 Cases

作　　者：江龙龙 卿松 Jiang Longlong;Qing Song(Chongqing Dazu District People's Hospital,Chongqing,China 402360)

机构地区：[1]重庆市大足区人民医院,重庆402360

出　　处：《中国药业》2018年第4期29-31,共3页China Pharmaceuticals

基　　金：重庆市大足区2014年度第二批科技计划项目[DZKJ2014ACC1077]

摘　　要：目的探讨脱乙酰壳多糖(chitosan,CS)预防术后肠粘连的临床效果及安全性。方法选取医院2015年9月至2016年9月收治的行腹部手术的患者80例,按照随机序列发生法均分为观察组和对照组,各40例,观察组患者关腹前采用脱乙酰壳多糖治疗,对照组患者直接关腹。结果观察组患者肛门排气时间、肠鸣音恢复时间、腹胀缓解时间、住院时间均短于对照组(P<0.05);观察组患者术后肠粘连发生率为40.00%,明显低于对照组的77.50%(P<0.05),且观察组患者Ⅱ~Ⅳ级肠粘连发生率低于对照组(P<0.05);观察组患者白细胞介素1(IL-1)、肿瘤坏死因子-α(TNF-α)、转化生长因子-β(TGF-β)水平均低于对照组(P<0.05)。结论脱乙酰壳多糖可抑制腹部手术患者细胞因子表达,降低肠粘连发生率,促进康复,缩短住院时间,且未出现明显排斥反应,安全性高,临床可推广。Objective To investigate the clinical effect and safety of chitosan for preventing postoperative intestinal adhesion.Methods Totally 80 patients undergoing abdominal surgery in our hospital from September 2015 to September 2016 were divided into the observation group and the control group according to random sequence generation method,4 0 cases in each group.The observation group was treated with chitosan before closing abdominal cavity,while the control group was closed cavity directly.Results The anal exhaust time,the recovery time of bowel sound,relief time of bloating and hospitalization time in the observation group were shorter than those in the control group(P<0.0 5).The incidence rate of intestinal adhesion in the observation group was 40.00%,which was significantly lower than 77.50%in the control group(P<0.0 5),and the incidence rate of n-V intestinal adhesion in the observation group was significantly lower than that in the control group(P<0.0 5).The levels of IL-1,TNF-a,TGF-P in the observation group were significantly lower than those in the control group(P<0.0 5).Conclusion Chitosan for treating patients with abdominal surgery can inhibit the expression of cytokines,reduce the incidence of intestinal adhesions,promote rehabilitation and shorten the hospitalization time.It has high safety without obvious rejection reaction,which is worthy of clinical promotion.

关 键 词：脱乙酰壳多糖 肠粘连 临床疗效 安全性 

分 类 号：R619[医药卫生—外科学]