几丁糖对大鼠术后腹腔粘连的预防作用

Effect of chitosan on the prevention of postoperative peritoneal adhesion in rats

目的 探讨几丁糖对术后腹腔粘连的预防作用。方法 将 45只大鼠随机分为对照组 (A组 ) ,右旋糖酐组 (B组 ) ,几丁糖组 (C组 ) ,于腹腔内浆膜损伤部位分别注入 1%乳酸液 ,3 2 %右旋糖酐 -70液 ,2 %几丁糖乳酸液各 2ml ,术后 14d处死动物 ,观察各组腹腔粘连状况并送病理检查。结果 3组粘连分级有显著性差异 (P <0 .0 1) ;C组粘连发生率较另 2组为低 ,有显著性差异 (P <0 .0 5 )。光镜下C组炎症反应轻微 ,纤维增生不明显 ;电镜下C组纤维细胞分泌胶原能力弱 ,间皮细胞增生活跃。结论 几丁糖可有效地降低大鼠术后腹腔粘连的发生和粘连程度 ,其作用优于右旋糖酐 -70 ,且不影响切口的愈合。

Objective To explore the effect of chitosan on the prevention of postoperative peritoneal adhesion. Methods Forty-five Wistar rats were randomly assigned into group A(control group);group B and group C;2 ml of 1% lactic acid, 32% Dextran-70 or 2% Chitosan-lactic acid (CLA) was admitted on the region of serosal injury of intestine respectively during operation. The adhesive degree was observed and biopsy was taken on the 14th postoperative day. Results There were statistically significant differences among the degrees of adhesions between the three groups (P<0.01);The adhesion incidence of group C was significantly less than that of the other two groups, and there were statistically differences between the group C and the other two groups (P<0.05). Mild inflammatory changes and less fibrous proliferation were observed in group C microscopically;decreased production of collagen (by fibroblast) and active mesothelial cells proliferation were observed in group C in electron microscopy. Conclusions CLA can effectively reduce the incidence and degree of postoperative peritoneal adhesion in rats, which is more satisfactory than Dextran-70. Meanwhile, CLA will not affect the wound healing.