凝胶化改性壳聚糖膜预防感染性腹膜粘连的对比研究

目的对比研究凝胶化改性壳聚糖膜和透明质酸钠对感染性腹膜粘连的预防作用。方法SD大鼠80只,随机分成四组:假手术对照组(A组),感染对照组(B组),凝胶化改性壳聚糖膜组(C组),透明质酸钠组(D组)。利用大鼠蚓突盲端制造感染性腹膜粘连模型,然后每组分别用相应的方法处理污染面,处理后2、4周打开腹腔,以Bha-tia分级法评定蚓突盲端的粘连程度,并对盲端组织行羟脯胺酸(OHP)水平测定和病理学检查。结果术后2周和4周,C组的粘连程度显著轻于B组(P=0.000),OHP水平显著低于B组(P=0.000);D组的粘连程度、OHP水平和B组无显著性差异(P>0.05)。病理学检查:B组术后2周局部组织以急性化脓性炎症为主,4周时以肉芽组织增生和纤维组织形成的慢性炎症反应为主;C、D组的病理改变类型同B组相同,但C组的上述改变较B组明显减轻,而D组和B组间则无明显差异。结论凝胶化改性壳聚糖膜具有明显的预防感染性腹膜粘连的作用,而透明质酸钠的作用则不明显。

Comparative study on the preventive effects of gelatinizedly-reshaped chitosan film on the bacteritic peritoneal adhesion

ObjectiveTo comparatively study the preventive effects of gelatinizedly-reshaped chitosan film (GRCF) and sodium hyalurate (SH) on the bacteritic peritoneal adhesion in rats. Methods80 Sprague-Dawley rats were randomly divided into four groups respectively: pseudo-operation group (Group A), bacteritic infection-control group (Group B), GRCF group(Group C) and SH group(Group D). The bacteritic peritoneal adhesive model was made in the caecums of vermiform processes of the rats, and the polluted surfaces were correspondingly treated with GRCF in Group C and SH in Group D. After two and four weeks of the treatments, the abdominal cavities were reopened and the adhesive severity was evaluated according to the Bhatia's method. The caecums of vermiform processes were resected for hydroxyproline (OHP) level detection and pathological examination. ResultsAfter two and four weeks, the adhesions were significantly lighter(P=0.000) and the OHP levels were significantly lower(P=0.000) in the Group C than those in the Group B, but there was no significant difference between the Group D and B(P>0.05). Pathological changes: In the Group B, the main pathological changes were acute suppurative inflammation after two weeks, and chronic inflammation with hyperblastosis of granulation and fibroplasias after four weeks. The types of pathological changes were similar in the Group C and D to those in the Group B, but degree of the pathological changes was lighter in the Group C than that in the Group B. There was no significant difference between degree of the pathological changes in the Group D and that in the Group B. ConclusionGRCF is much effective on preventing bacteritic peritoneal adhesion, however, the preventive effect of SH is not obvious.