医用透明质酸钠凝胶的防粘连作用及对伤口愈合、抗生素作用的影响  

Anti-adhesive effect of medical sodium hyaluronate gel and its effect on wound healing and antibiotics

作　　者：蔡同凯 韩华[2] 曹永兵 阎澜 CAI Tongkai;HAN Hua;CAO Yongbing;YAN Lan(Faculty of Pharmacy,Naval Medical University,Shanghai 200433,China;School of Medicine,Tongji University,Shanghai 200092,China;Institute of Vascular Diseases,Shanghai Hospital of Integrated Traditional Chinese and Western Medicine,Shanghai 200082,China)

机构地区：[1]海军军医大学药学系,上海200433 [2]同济大学医学院,上海200092 [3]上海中西医结合医院脉管病研究所,上海200082

出　　处：《药学服务与研究》2020年第2期92-97,共6页Pharmaceutical Care and Research

摘　　要：目的:考察医用透明质酸钠凝胶(medical sodium hyaluronate gel,MSHG)对大鼠腹腔手术后的防粘连作用和体外抑菌作用的影响。方法:取50只SD大鼠,建立盲肠和腹壁双侧损伤模型,将大鼠随机分为假手术组、模型组、低剂量组(MSHG 0.15 ml/cm^2)、高剂量组(MSHG 0.30 ml/cm^2)和阳性对照组(阳性对照MSHG 0.15 ml/cm^2),每组10只。术后以Nair粘连5级分类法对腹腔粘连进行评分,用张力仪测量腹壁两侧肌肉的极限载荷并计算刚度比,考察MSHG的防粘连作用和对损伤肌肉组织愈合的影响。采用体外倍比稀释法考察MSHG对大肠杆菌和金黄色葡萄球菌生长的影响,用琼脂打孔扩散抑菌圈法考察MSHG对5种抗生素扩散的影响。结果:模型组粘连评分为3.60±1.26,假手术组粘连评分为0.10±0.32,低剂量组粘连评分为2.33±1.70,高剂量组粘连评分为1.67±1.44,与模型组比较,差异均有统计学意义(P<0.001或P<0.05);低剂量组和高剂量组极限荷载比和刚度比分别与假手术组和模型组相比,差异无统计学意义(P>0.05);不同浓度的MSHG对大肠杆菌和金黄色葡萄球菌的生长均无促进作用,且在较高浓度下显现出一定的抑制作用;抗生素联用MSHG组与抗生素单用组比较,抑菌圈面积大小差异无统计学意义(P>0.05)。结论:MSHG对大鼠术后腹腔粘连具有显著防护作用,显示出剂量依赖性;高浓度MSHG对细菌有抑制作用,未见对抗生素药效的影响。Objective:To investigate the anti-adhesive effect of medical sodium hyaluronate gel(MSHG)after abdominal operation in rats and its anti-bacterial activity in vitro.Methods:Fifty SD rats were used to establish caecum and bilateral abdominal wall injury models,and were randomly divided into the sham operation group,the model group,the low-dosage group(MSHG 0.15 ml/cm^2),the high-dosage group(MSHG 0.30 ml/cm^2)and the positive control group(positive control MSHG 0.15 ml/cm^2),each consisting of 10 rats.The Nair 5-grade classification method was used to evaluate scores of abdominal adhesion,and the tension instrument was applied to measure the ultimate load of the muscles on both sides of the abdominal wall and calculate the stiffness ratio.Ultimately,the anti-adhesive effects of MSHG and its effect on healing of injured muscle tissue were investigated.Broth microdilution and agar diffusion method were used to study the effect of MSHG on the growth of Escherichia coli(E.coli)and Staphylococcus aureus(SA),as well as on the spread of five antibiotics.Results:The adhesion scores for the model group,the sham operation group,the low-dosage group and the high-dosage group were(3.60±1.26),(0.10±0.32),(2.33±1.70)and(1.67±1.44),respectively.As compared with the model group,statistical significance could be clearly noticed(P<0.001 or P<0.05).However,no statistical significance could be noted,when the ultimate load ratio and the stiffness ratio were compared between the low-dosage group and the high-dosage group(P>0.05).Different concentrations of MSHG did not have enhancing effects on the growth of E.coli and SA,and seemed to have a certain inhibitive effect at a higher concentration.Statistical significance could neither be seen in the size of the inhibition area,when the antibiotics combined with MSHG group was compared with the simple antibiotic group(P>0.05).Conclusion:MSHG has a significant dosage-dependent anti-adhesive effect on postoperative abdominal adhesion in rats.High concentration of MSHG has an inhibitory ef

关 键 词：医用透明质酸钠凝胶 粘连 极限载荷 刚度 

分 类 号：R961[医药卫生—药理学]