聚乳酸/乙醇酸可吸收医用膜对兔腹腔术后粘连的预防作用研究

摘要

Objective To investigate the effects of PLGA absorbable membrane in prevention of postoperative abdominal adhesion in rabbits.Methods 66 Japanese white rabbits were randomly divided into three groups: the normal control groupn=6, model control groupn=30 and PLGA groupn=30. Rabbits were received multifactor methods to establish postoperative abdominal adhesion models except for normal control group. The cecum wound was covered PLGA membrane in the PLGA group. At postoperative 1, 2, 4, 6 and 12 weeks, the abdominal cavities were reopened and the adhesive severity was graded blindly, and the hydroxyproline level in cecum tissue was measured and the cecum histopathology was observed. Results (1) the degree of adhesion and hydroxyproline level in model control group were significantly higher than those of normal control group (P<0.05,P<0.01), while the degree of adhesion and hydroxyproline level in PLGA group were significantly lower than those of model control group (P<0.05). (2) HE staining showed that cecum serosa had obviously inflammatory cellinfiltration andfibroblast proliferation, while PLGA could inhibit fibroblast proliferation and reduce the inflammatory cellinfiltration and colagen.Conclusion PLGA absorbable membrane can inhibit fibroblast proliferation and collagen to prevent the experimental postoperative peritoneal adhesions.%目的：研究聚乳酸/乙醇酸可吸收医用膜对兔腹腔术后粘连的预防作用。方法日本大耳白兔66只，随机分成3组，正常对照组n=6，模型对照组n=30，PLGA膜组n=30。除正常对照组外均采用多因素法复制腹腔术后粘连模型，PLGA膜组在盲肠创面贴敷PLGA膜。术后1、2、4、6、12周后打开腹腔，评定腹膜粘连程度，并对盲肠组织行羟脯氨酸水平测定和HE组织病理学观察。结果(1)模型对照组的粘连程度和羟脯氨酸水平均明显高于正常对照组(P<0.05,P<0.01)，且PLGA膜组的粘连程度和羟脯氨酸水平均显著低于模型对照组(P<0.05)。(2) HE染色显示模型对照组盲肠浆膜层有明显的炎症细胞浸润和纤维组织增生。PLGA膜能抑制纤维细胞的增生，炎症细胞浸润减少和胶原纤维明显减少。结论 PLGA膜能抑制成纤维细胞的增生和胶原蛋白的形成，减轻了兔术后粘连发生的程度和范围。