奥曲肽联合透明质酸钠预防兔术后腹膜粘连的疗效评价

Preventive effect of octreotide combined with sodium hyaluronate on postoperative intraperitoneal adhesions in rabbits

目的观察奥曲肽联合透明质酸钠预防兔术后腹膜粘连的效果。方法建立兔术后腹膜粘连模型,然后分为4组(1)术中不用药物处理设为模型对照组;(2)关腹前局部涂抹透明质酸钠设为透明质酸钠组;(3)关腹前腹腔内注射奥曲肽设为奥曲肽组;(4)关腹前局部涂抹透明质酸钠同时腹腔内注射奥曲肽设为联合组。术后14d剖腹观察,判定腹膜粘连程度等级。结果4组粘连发生率比较无统计学意义(χ2=3.51,P>0.05);联合组重度粘连发生率(8.3%)显著低于其它3组(分别为66.7%,33.3%,25.0%)(均P<0.01)。奥曲肽组和透明质酸钠组两组的粘连级别近似(P>0.05)。结论奥曲肽和透明质酸钠均可减轻实验性腹膜粘连的程度和重度腹膜粘连发生率,两者合用其作用更明显,表明两药合用具有降低粘连的协同作用。

Objective To investigate the preventive effect of octreotide combined with sodium hyaluronate on postoperative abdominal adhesions in rabbits. Methods The established postoperative abdominal adhesion models were divided into 4 groups ： （ 1 ） without use of octreotide or sodium hyaluronate （ model control group ） ; （ 2 ） local application of sodium hyaluraronate （ HA group ） before closure of abdomen ; （ 3 ） intraperitoneal injection of octreotide （ OC group ） , （ 4 ） local application of sodium hyaluronate and peritoneal injection of octreotide 20ug/kg（OC ＋ HA group）, relaparotomy was done 14 days later, and the adhesion extent was judged. Results Incidence rates of abdominal adhesion on the day 14 after the operation betweent the 4 groups were not different （ P 〉 0. 05 ）. However, the incidence rates of severe abdominal adhesion were different （P 〈 0.05）. In OC ＋ HA group was significantly lower than that in the model control group, octreotide group and HA group （ P 〈 0.05 ） ; and no significant difference between the octreofid group and sodium hyaluronate group （P 〉 0. 05 ）. Conclusions Combination of octreotide and sodium hyaluronate have the synergetic preventive action on the degree and rate of formation of severe peritoneal adhesions after abdominal operation in rabbits.