壳聚糖DCX-16对术后腹膜粘连的防治作用

Effect of chitosan DCX-16 on postoperative peritoneal adhesions in rats

目的:探讨壳聚糖DCX-16对术后腹膜粘连的防治作用。方法:采用盲肠浆膜擦伤的方法建立大鼠腹膜粘连的动物模型。分别在创伤局部给予5 mL·kg-1的生理盐水、透明质酸钠(50 mg·kg-1)和壳聚糖DCX- 16(15,50,150,500 mg·kg-1),观察术后d 14腹膜粘连和切口愈合情况。选用最有效浓度的壳聚糖DCX-16, 比较其与生理盐水、透明质酸钠对大鼠术后d 3,7,14,21腹膜粘连形成的影响。结果:术后d 14对照组(用生理盐水)粘连发生率100％。粘连程度壳聚糖DCX-16各剂量组与对照组差异非常显著(P<0．01),与透明质酸钠组无显著差异(P>0．05)。取150 mg·kg-1壳聚糖DCX-16为最佳有效剂量,其可明显减轻大鼠术后 d 3创面出血和术后d 7,14,21时的腹膜粘连。结论:壳聚糖DCX-16可明显减少术后腹膜粘连的发生及严重程度。

AIM ： To investigate the preventive effects of chitosan DCX- 16 （DCX-16） on postoperative peritoneal adhesions in rats. METHODS： The peritoneal adhesion model of Wistar rats was made by abrasing cecum serosa membrane. The groups were treated locally at traumatized cecum with 5 mg·kg^-1 normal saline, sodium hyaluronate （50 mg·kg^-1）, or DCX-16 （ 15,50,150,500 mg·kg^-1） respectively during the operation. The degrees of peritoneal adhesion and incision healing were evaluated at d 14 postoperatively in order to find the most effective concentration of DCX-16 for the adhesion. The animals dealt with the most effective concentration DCX-16,normal saline or sodium hyaluronate were sequentially sacrificed at postoperative d 3, 7, 14, 21 respectively, in order to compare their influence on adhesions gradation according to their severity. RESULTS：The adhesive rate reached 100 % on d 14 postoperatively in the control group （normal saline） showing significant difference with the various concentrations in DCX-16 groups （P 〈 0.01 ）, but there was no obvious difference between sodium hyaluronate group and DCX-16 groups（P 〉 0.05）. DCX-16 150 mg·kg^-1 was taken as the most optimal concentration and it revealed the conspicuous reduction of traumatic surface bleeding on d 3 and peritoneal adhesion on d 7, 14, 21 postoperatively in rats. CONCLUSION： DCX-16 can decrease obviously the incidence and the seriousness of postoperative peritoneal adhesions in rats.