可生物降解热敏性改性甲壳素水凝胶预防术后肠粘连效果的研究

Postoperative Adhesion Prevention with a Thermosensitive Injectable in situ Forming Carboxymethyl Chitin Hydrogel

目的：探究可生物降解热敏性改性甲壳素凝胶在动物肠壁-腹壁损伤模型中预防术后肠粘连的效果。方法：首先在体外细胞实验中探究了凝胶的生物相容性。然后建立了新西兰兔盲肠侧壁-腹壁损伤肠粘连模型,对比了改性甲壳素凝胶和商用几丁糖凝胶预防术后粘连的效果。观察凝胶在体内的降解情况,以及凝胶是否会对主要器官产生毒性损害。结果：溶血试验中凝胶与生理盐水溶血程度无显著差别（P〉0.05）,表明凝胶不会溶血。细胞毒性试验发现,与凝胶直接接触肠上皮细胞的细胞活性与未接触凝胶的对照组无显著差异（P〉0.05）,表明凝胶不会对细胞生长增殖造成影响。动物实验中,两种凝胶减少了粘连形成,并且改性甲壳素凝胶还减小形成粘连的面积。结论：可生物降解热敏性改性甲壳素凝胶生物相容性良好,能减少术后肠粘连的发生,是一种具有潜在临床应用价值的防粘连屏障材料。

Objective：To investigate whether the injectable biodegradable thermosensitive in situforming chemically modified carboxymethyl chitin hydrogel can be used to prevent postoperative adhesion formation.Methods：We first confirmed biocompatibility of the hydrogel in vitro by using hemolysis assay and cell viability assay,then a postoperative adhesion rabbit model of sidewall defect-bowel abrasion was established and the anti-adhesion effect of the hydrogel comparing with another commercially available chitin hydrogel was evaluated in the animal model in vivo.Results：In vitro experiments,the hydrogel did not cause significant hemolysis,nor did it affect cell growth and proliferation,confirming the excellent biocompatibility of the hydrogel.In the in vivo experiment of animal model,we found that the hydrogel degraded completely 3 weeks after applied,and comparing with the commercially available chitin hydrogel,our hydrogel tended to be more effective in preventing postoperative adhesion formation,and it also reduced the area of the formed adhesion.Conclusion：The injectable biodegradable thermosensitive in-situ formingchemically modified carboxymethyl chitin hydrogel is a promising barrier system for prevention of postoperative adhesion.