多聚合纤维素防止手术后粘连的基础与临床应用的前瞻性系列研究

Effect of Polycarboxy methylcellulose (Poly-CMC) in Prevention of Postoprative Adhesions.A Serial of Experimental and Clinical Prospective Study

目的 :研制一种新型的非生物性可吸收的防粘连材料—多聚合纤维素 (Poly CMC) ,观察其动物实验与临床疗效。方法 :分动物实验和临床应用实验两阶段。第一阶段 1993～ 1996年应用赛克鸡、SD大鼠、新西兰大白兔为动物实验模型 ,分别观察Poly CMC在防止肌腱、神经、硬膜、关节及腹腔术后粘连的效果。第二阶段 :1997～ 1999年观察了Poly CMC在临床防止肌腱粘连的疗效。结果 :Poly CMC局部可存留 6～ 8周。动物实验和临床防治粘连效果明显优于其他对照组 ,用后无明显的组织学炎性及排异反应和病理性超微结构变化 ,提示Poly CMC具有良好的组织生物相容性。结论 :Poly CMC是一种理想的防粘连材料 ,能防止外科术后的粘连 ,且成本低 ,易于保存 ,应用简便 ,有开发价值。

Objective: To investigate the effect of a new kind of nonbiological material polycarboxymethylcellulose (Poly CMC) in the prevention of postoperative adhesions.Method:A two stage of prospectively experimental and clinical studies were done.In first stage,from 1993 to 1996,a serial experiments were preformed in 20 chickens,212 SD rats,48 New Zealand white rabbit to evaluate the effectiveness of Poly CMC in prevention of tendons,nerve,joint peridural and peritoneal adhesions;a second stage was done from 1993 to 1999 on 75 patients to determine the effectiveness of the Poly CMC in prevention of tendon and joint adhesion in hands.Result:Poly CMC,as a three dimensional absorbable material,playing its effect for 6～8 weeks in suite,not only in experimental,but also in clinic could effectively prevent adhesions in contrast with another experimental groups and have no evident inflammatory and heterogeneous reactions as well as pathological ultra structure abnormal postoperatively.Conclusion:Poly CMC is an effective and potential material in prevention of adhesions after surgery.