Güzelsağaltici Nihat, Girgin Sadullah, Gedik Ercan, Büyükbayram Hüseyin, Baç Bilsel
Department of General Surgery, School of Medicine, University of Dicle, Diyarbakir, Turkey.
Acta Obstet Gynecol Scand. 2007;86(4):395-400. doi: 10.1080/00016340701267108.
Peritoneal adhesion is a common complication following abdominal surgery. Despite recent advances in diagnosis and treatment, it still presents a problem for the patients and surgeons. In the present study, we investigated the effects of octenidindihydro-chloride - phenoxyethanol (OCP) on peritoneal adhesions.
Rats were divided into four groups: Group 1 (saline), Group 2 (peritonitis plus saline), Group 3 (OCP), and Group 4 (peritonitis plus OCP). Peritonitis was induced in the rats of Groups 2 and 4. The abdominal cavities of the rats in Groups 1 and 2 were washed with saline, while those of the rats in Groups 3 and 4 were irrigated with 1:10 OCP solution. Adhesion and fibrotic scores were determined by re-laparotomy after 21 days.
The adhesion scores in Groups 1 (saline), 2 (peritonitis plus saline), 3 (OCP) and 4 (peritonitis plus OCP) were 3.30+/-0.94, 5.25+/-1.03, 1.12+/-0.83 and 0.28+/-0.48, respectively. Statistical analysis of adhesion scores revealed significant differences between groups, except between Groups 3 and 4 (p=0.265). Statistical analyses of grades of histopathological signs showed that Group 1 differed from Groups 2 and 4 (p=0.004, p=0.003, respectively); Group 2 differed from Groups 3 and 4 (p=0.001, p=0.001, respectively). On the other hand, differences between Group 3 and Groups 1 and 4 were not significant (p=0.06, p=0.08, respectively).
OCP decreased the peritoneal adhesion formation macroscopically and microscopically in the presence or absence of peritonitis. Peritoneal defects due to trauma are to be left open and OCP diluted 1:1 should not be used intraperitoneally.
腹膜粘连是腹部手术后常见的并发症。尽管近年来在诊断和治疗方面取得了进展，但它仍然给患者和外科医生带来问题。在本研究中，我们研究了盐酸奥替尼啶 - 苯氧乙醇（OCP）对腹膜粘连的影响。
将大鼠分为四组：第1组（生理盐水组）、第2组（腹膜炎加生理盐水组）、第3组（OCP组）和第4组（腹膜炎加OCP组）。对第2组和第4组大鼠诱导腹膜炎。第1组和第2组大鼠的腹腔用生理盐水冲洗，而第3组和第4组大鼠的腹腔用1:10的OCP溶液冲洗。21天后通过再次剖腹手术确定粘连和纤维化评分。
第1组（生理盐水组）、第2组（腹膜炎加生理盐水组）、第3组（OCP组）和第4组（腹膜炎加OCP组）的粘连评分分别为3.30±0.94、5.25±1.03、1.12±0.83和0.28±0.48。粘连评分的统计分析显示组间存在显著差异，但第3组和第4组之间除外（p = 0.265）。组织病理学征象分级的统计分析表明，第1组与第2组和第4组不同（分别为p = 0.004，p = 0.003）；第2组与第3组和第4组不同（分别为p = 0.001，p = 0.001）。另一方面，第3组与第1组和第4组之间的差异不显著（分别为p = （此处原文有误，推测应为p = 0.06），p = 0.08）。
无论有无腹膜炎，OCP均可在宏观和微观上减少腹膜粘连的形成。因创伤导致的腹膜缺损应保持开放，不应腹腔内使用1:1稀释的OCP。
