Reijnen M M, Skrabut E M, Postma V A, Burns J W, van Goor H
Department of Surgery, University Medical Center Nijmegen, Nijmegen, The Netherlands.
J Surg Res. 2001 Dec;101(2):248-53. doi: 10.1006/jsre.2001.6288.
Intra-abdominal infection is complicated by adhesion and abscess formation. We have assessed the adhesion- and abscess-reducing capacity of various solution volumes and concentrations of two polyanionic polysaccharides, hyaluronan (HA) and carboxymethylcellulose (CMC), in a rat peritonitis model.
In 192 male Wistar rats a bacterial peritonitis was induced using cecal ligation and puncture. After 24 h the abdomen was reopened and the ligated cecum resected. Animals were randomized into three control groups, nine groups treated with various solution volumes (1 to 8 ml) containing different HA concentrations, and four groups treated with 1.7% CMC solution. Rats were killed at day 7, postoperatively, and adhesions were scored at five abdominal sites on a scale from 0 to 4. The presence and size of intra-abdominal abscesses were noted.
Fifty-four rats (28%) prematurely died. There was no significant difference in mortality between treatment groups and controls. Treatment with CMC (P < 0.001) and low (0.2 and 0.4%) concentrations of HA (P < 0.005) significantly reduced intra-abdominal adhesion formation. High volumes of 0.2 and 0.4% HA were most effective (P = 0.01). The effect of CMC was volume independent. The incidence of abdominal abscesses was also significantly reduced by treatment with either CMC (P < 0.001) or low concentrations of HA (P < 0.001). With regard to abscess formation the effect was independent of the volume administered for HA, while low volumes of CMC were most effective (P < 0.005).
Intraperitoneal treatment with either CMC or low-viscosity HA solution reduced intra-abdominal adhesion and abscess formation in a rat peritonitis model. The volume-induced reduction in adhesion formation suggests a hydroflotation effect of HA solution.
腹腔内感染会并发粘连和脓肿形成。我们在大鼠腹膜炎模型中评估了两种聚阴离子多糖（透明质酸（HA）和羧甲基纤维素（CMC））不同溶液体积和浓度减少粘连和脓肿的能力。
在192只雄性Wistar大鼠中，采用盲肠结扎和穿刺诱导细菌性腹膜炎。24小时后打开腹腔，切除结扎的盲肠。动物被随机分为三个对照组、九个用含不同HA浓度的不同溶液体积（1至8毫升）治疗的组以及四个用1.7% CMC溶液治疗的组。术后第7天处死大鼠，并对腹部五个部位的粘连情况按0至4分进行评分。记录腹腔内脓肿的存在情况和大小。
54只大鼠（28%）过早死亡。治疗组和对照组之间的死亡率无显著差异。CMC治疗（P < 0.001）以及低浓度（0.2%和0.4%）的HA治疗（P < 0.005）显著减少了腹腔内粘连的形成。高体积的0.2%和0.4% HA最为有效（P = 0.01）。CMC的效果与体积无关。CMC治疗（P < 0.001）或低浓度HA治疗（P < 0.001）也显著降低了腹腔脓肿的发生率。关于脓肿形成，HA的效果与给药体积无关，而低体积的CMC最为有效（P < 0.005）。
在大鼠腹膜炎模型中，腹腔内注射CMC或低粘度HA溶液可减少腹腔内粘连和脓肿形成。HA溶液因体积导致的粘连形成减少提示了其水浮选作用。
