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医用自交联透明质酸钠凝胶对肠吻合和切口愈合的影响

Effect of medical self-crosslinked sodium hyaluronate gel on intestinal anastomosis and incision healing

    摘要
  • 摘要:
    目的  探讨医用自交联透明质酸钠凝胶对大鼠肠吻合口愈合、腹壁切口愈合及存活率的影响。
    方法  常规饲养健康成年雄性SD大鼠76只，选取其中64只大鼠建立结肠吻合口模型，随机分为实验组和对照组，每组32只，其余12只大鼠设为未手术组。实验组大鼠结肠吻合口部位用1 mL医用自交联透明质酸钠凝胶涂敷，对照组大鼠吻合口不做任何处理。观察对照组、实验组大鼠的存活率，术后7、14 d分别检查实验组、对照组大鼠腹壁切口和腹膜/肌层愈合情况，并基于抗张强度对大鼠进行肠吻合口愈合评价。
    结果  对照组、实验组大鼠术后生命体征平稳，逐渐恢复独立活动能力，均未出现死亡和感染情况，存活率为100.00%。术后7、14 d, 实验组大鼠腹壁切口愈合情况和腹膜/肌层愈合情况与对照组比较，差异均无统计学意义(P>0.05)。对照组、实验组大鼠术后7、14 d的肠吻合口抗张强度均低于未手术组大鼠正常结肠抗张强度，差异有统计学意义(P < 0.05); 术后7、14 d，实验组大鼠肠吻合口抗张强度均高于对照组，差异有统计学意义(P < 0.05)。
    结论  医用自交联透明质酸钠凝胶可显著提高大鼠结肠吻合口的抗张强度，且不影响腹壁切口和腹膜/肌层愈合。

     

    Abstract:
    Objective  To investigate the effect of medical self-crosslinking sodium hyaluronate gel on intestinal anastomosis healing, abdominal wall incision healing and survival rate in rats.
    Methods  A total of 76 healthy adult male SD rats were routinely bred, 64 rats were selected to establish colonic anastomosis model and randomly divided into experimental group and control group, with 32 rats in each group. The remaining 12 rats were assigned to non-operation group. The colonic anastomosis of rats in the experimental group was coated with 1 mL medical self-crosslinking sodium hyaluronate gel, while the anastomosis of rats in the control group was not treated. The survival rate of rats in the control group and the experimental group was observed. The abdominal wall incision and peritoneal or muscular healing of rats in the experimental group and the control group were examined 7 and 14 days after operation, and the healing conditions of intestinal anastomosis in rats were evaluated based on the tensile strength.
    Results  The vital signs of all animals after surgery were stable, and animals gradually restored the ability of independent activities, there were no dead and infected rates in two groups, with the survival rate of 100.00%. At 7 d or 14 d after operation, there were no significant differences in abdominal wall incision healing and peritoneal or muscular layer healing between the experimental group and the control group (P>0.05). The tensile strength of intestinal anastomosis in control group and experimental group was lower than that of normal colon in the non-operation group on the 7th and 14th days after operation (P < 0.05). On the 7th and 14th day after operation, the tensile strength of the intestinal anastomosis of the experimental group was higher than that of the control group (P < 0.05).
    Conclusion  Medical self-crosslinking sodium hyaluronate gel can significantly improve the tensile strength of colonic anastomosis in rats, and has no influences on abdominal wall incision and peritoneal or muscular healing.

     

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