载药缓释敷料对兔开放创面愈合的影响  

Effect of drug loading and sustained release dressings on open wound healing in rabbits

作　　者：耿磊[1] 张国强[1] 倪明[1] 任鹏[1] 刘浩[1] 孙菁阳 郑清源 程龙 黄靖香[1] GENG Lei;ZHANG Guo-qiang;NI Ming;REN Peng;LIU Hao;SUN Jing-yang;ZHENG Qing-yuan;CHENG Long;HUANG Jing-xiang(Department of Orthopedics,General Hospital of CPLA,Beijing 100853,China)

机构地区：[1]中国人民解放军总医院骨科,北京100853

出　　处：《中国矫形外科杂志》2021年第24期2257-2260,共4页Orthopedic Journal of China

基　　金：国家重点研发计划项目(编号:2020YFC2004903-ZGQ)。

摘　　要：[目的]研制止血、止痛、抗菌多功能一体的应用于开放战创伤的新型敷料并评价其疗效.[方法]将壳聚糖、醋酸、聚乙烯醇、蒸馏水溶液、氨甲环酸、罗哌卡因以及纳米银按照一定的比例和浓度配置溶液并通过静电纺丝制备纤维膜.通过紫外线分光光度计测定此三种药物的体外累积释放度.16只大耳白兔制作开放伤兔模型,随机分为新型敷料组8只,和传统敷料组8只,用相应敷料覆盖创面.评估出血量、兔疼痛评分、C反应蛋白(CRP)、创口组织病理切片中5个多形核粒细胞(polymorphonuclear granulocytes,PMN)最多的高倍镜视野中的平均值、创口完全愈合需要的时间.[结果]此三种药物累积释放量达到50%时需要大约12h,而20h时达到释放平衡;新型敷料组失血量、术后第1d平均疼痛指数、术后第3 d CRP、PMN均数及伤口愈合时间显著低于传统敷料组,差异有统计学意义(P<0.05),而术后第7d疼痛指数、术后第1 d CRP及术后第1 d PMN均数两组差异无统计学意义(P>0.05).[结论]载氨甲环酸、罗哌卡因及纳米银的壳聚糖/聚乙烯醇静电纺丝纤维缓释敷料可稳定缓释药物,并对兔战创伤模型具有止血、止痛、抗感染及促进伤口愈合的作用.[Objective]To develop a new type of multifunctional dressing for hemostasis,analgesia and antibacterial for open war trauma and evaluate its efficacy.[Methods]The dressing was prepared by electrostatic spinning with chitosan,acetic acid,polyvinyl alcohol,distilled water solution,tranexamic acid,ropivacaine and nano-silver.The cumulative release of the three drugs in vitro was determined by ultraviolet spectrophotometer.Sixteen rabbits were used to create an open wound,and were randomly divided into the new dressing group(n=8)and the traditional dressing group(n=8).The wound surface was covered with the corresponding dressing.The two groups were compared regarding to the amount of blood loss,rabbit pain score,C-reactive protein(CRP),the mean count of polymorphonuclear granulocytes(PMNs)in 5 high power fields in wound histopathological observation,and time elapsed for complete wound healing were evaluated.[Results]It took about 12 hours for the cumulative release of the three drugs to reach 50%,and 20 hours for the equilibrium release.The new dressing group proved significantly superior to the traditional dressing group in term of blood loss,pain score 1 day postoperatively,CRP and PMN 3 days postoperatively,as well as wound healing(P<0.05),despite of the fact that there were no significant differences in pain score at 7 days,CRP and PMN at 1 day postoperatively between the two groups(P>0.05).[Conclusion]This chitosan,polyvinyl alcohol electro spined dressing loaded with tranexamic acid,ropivacaine and nano-silver does stabilize for sustained release of the drugs,and has the effects of hemostasis,analgesia,anti-infection and promoting wound healing in war wound rabbit model.

关 键 词：壳聚糖/聚乙烯醇 静电纺丝 氨甲环酸 罗哌卡因 纳米银 战创伤 

分 类 号：R683[医药卫生—骨科学]