Tanaka A, Abe T, Matsuura A
Department of Thoracic and Cardiovascular Surgery, Sapporo Medical University School of Medicine, South 1, West 16, Chuo-ku, Sapporo 060-8543, Japan.
Ann Thorac Cardiovasc Surg. 2000 Jun;6(3):151-60.
For the purpose of reducing the risk of lung injury while separating adhesions in repeated pulmonary resections, the inhibitory effect of hyaluronate based bioresorbable membrane (HA membrane) on postoperative adhesions was investigated in a new pleural adhesion model in rats. First of all, a novel post-thoracotomy adhesion model in rats was successfully established by using a combination of mechanical, chemical and ischemic injuries of the pleura during operation. After undergoing the same adhesion-inducing procedures, one of two groups was treated with HA membrane inserted between the lung and the parietal pleura, and the other group underwent infusion of saline only. The severity of the adhesion formation was macroscopically lower in the HA membrane-treated rats, and they had favorable mesothelial regeneration microscopically. Additionally, the activity of type 1 plasminogen activator inhibitor (PAI-1) in the intrapleural lavage fluid (ILF) was measured at 24 hours postoperatively because this is the main influence on adhesion formation after surgery. PAI-1 activity was 23.37+/-2.57 U/ml in the saline-treated group and 17.85+/-3.06 U/ml in the HA membrane-treated group. The result suggests that the HA membrane inhibits postoperative adhesion formation through a significant repression of PAI-1 activity.
为了在重复肺切除术中分离粘连时降低肺损伤风险，在一种新的大鼠胸膜粘连模型中研究了基于透明质酸盐的生物可吸收膜（HA膜）对术后粘连的抑制作用。首先，通过手术期间对胸膜进行机械、化学和缺血性损伤相结合的方法，成功建立了一种新型大鼠开胸后粘连模型。在经历相同的粘连诱导程序后，两组中的一组在肺与壁层胸膜之间插入HA膜进行治疗，另一组仅输注生理盐水。HA膜治疗的大鼠粘连形成的严重程度在宏观上较低，并且在微观上具有良好的间皮再生。此外，在术后24小时测量胸腔灌洗液（ILF）中1型纤溶酶原激活物抑制剂（PAI-1）的活性，因为这是术后对粘连形成的主要影响因素。生理盐水治疗组的PAI-1活性为23.37±2.57 U/ml，HA膜治疗组为17.85±3.06 U/ml。结果表明，HA膜通过显著抑制PAI-1活性来抑制术后粘连形成。
