聚乳酸/乙醇酸膜预防兔腹腔术后粘连的实验研究

Experimental Research on the Prevention of Rabbit Postoperative Abdominal Cavity Adhesion with PLGA Membrane

为探讨聚乳酸/乙醇酸(PLGA)膜对兔腹腔术后粘连的预防作用及其机制。将66只日本大耳白兔随机分成正常对照组、模型对照组和PLGA膜组。除正常对照组外,其余各组均采用多因素法制作兔腹腔术后粘连模型,PLGA膜组创面贴覆PLGA膜,模型对照组创面不处理,并在不同时间点测定血常规、血浆肝肾功能和纤维蛋白原含量,分别在术后1、2、4、6、12周时,处死动物并评定腹腔粘连程度。取盲肠组织行Masson染色和转化生长因子-β1(TGF-β1)免疫组化法,观察胶原纤维的增生和TGF-β1阳性表达情况。术后粘连程度显示PLGA膜组明显低于模型对照组,并对肝肾功能、血常规指标均无明显影响,但分别在术后1周和2周能显著降低纤维蛋白原含量和白细胞数目,并且胶原纤维面密度和TGF-β1的总光密度均显著低于模型对照组。结果表明,PLGA膜可有效预防兔腹腔术后粘连,其与减少纤维蛋白原的渗出,抑制胶原纤维组织的增生和TGF-β1的过表达有关。

The aim of this paper is to explore the prevention of rabbit postoperative abdominal cavity adhesion with poly（lactic-co-glycotic acid）（PLGA）membrane and the mechanism of this prevention function.Sixty-six Japanese white rabbits were randomly divided into normal control group,model control group and PLGA membrane group.The rabbits were treated with multifactor methods to establish the postoperative abdominal cavity adhesion models except for those in the normal control group.PLGA membrane was used to cover the wounds of rabbits in the PLGA membrane group and nothing covered the wounds of rabbits in the model control group.The hematologic parameters,liver and kidney functions and fibrinogen contents were detected at different time.The rabbit were sacrificed 1,2,4,6,12 weeks after the operations,respectively.The adhesions were graded blindly,and Masson staining and immunohistochemistry methods were used to observe the proliferation of collagen fiber and the expression of transforming growth factorβ1（TGF-β1）on the cecal tissues,respectively.The grade of abdominal cavity adhesion showed that the PLGA membrane-treated group was significant lower than that in the model control group,and it has no influence on liver and kidney function and hematologic parameters.But the fibrinogen content and the number of white blood cell in the PLGA membrane group were significant lower than those of model control group1 week and 2weeks after operation,respectively.The density of collagen fiber and optical density of TGF-β1in the PLGA membrane group were significant lower than those of model control group.The results demonstrated that PLGA membrane could be effective in preventing the abdominal adhesions in rabbits,and it was mostly involved in the reducing of fibrinogen exudation,and inhibited the proliferation of collagen fiber and over-expression of TGF-β1.