Rasti Mehdi, Parvaresh Ehsan, Tavajoh Saeideh, Talaei Mohammad
Faculty of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.
Int J Surg. 2007 Dec;5(6):384-7. doi: 10.1016/j.ijsu.2007.04.013. Epub 2007 May 10.
The purpose of this study was to determine the effects of diphenhydramine HCl and Nedocromil sodium for the prevention of postsurgical adhesion formation in rat model.
Sixty adult female rats were anesthetized by 5mg/kg ketamine hydrochloride. After opening the abdominal wall, a 2 cm(2) peritoneal layer was excised from the left abdominal wall and 10 longitudinal incisions of 2 to 3 cm in length were made on the right parietal peritoneum. The abdominal wall was closed with 4/0 atraumatic continuous nylon sutures. Group I was the control group, group II was given 10mg/kg diphenhydramine HCl, group III was given 100mg/kg Nedocromil sodium, and group IV was administered both drugs in the above doses. All the drugs were instilled into the peritoneal cavity after abdominal closure except Nedocromil sodium which was administered in two separate doses 30 min before surgery and just after abdominal closure. Relaparatomy was performed 2 weeks after the initial surgery and abdominal adhesions were scored. Kruskal-Wallis and Mann-Whitney U-test were used for the statistical evaluation.
The mean+/-S.D. (median) of adhesion scores were 2.5+/-0.90 (2.0), 1.58+/-0.99 (1.0), 0.92+/-0.86 (1.0) and 1.75+/-0.75 (2.0) in group I, II, III and IV, respectively. There were significant differences between the scores of groups I and II (P=0.033), groups I and III (P<0.001), and groups I and IV (P=0.033).
Both diphenhydramine HCl and Nedocromil sodium reduced postoperative abdominal adhesions separately and in combination with each other in our study. Average score of adhesion formation was lowest in the group that was administered Nedocromil sodium. More research is needed in order to discover any positive effect of these drugs as antiadhesive agents in humans.
本研究旨在确定盐酸苯海拉明和奈多罗米钠对大鼠模型术后粘连形成的预防作用。
60只成年雌性大鼠用5mg/kg盐酸氯胺酮麻醉。打开腹壁后，从左腹壁切除2cm²的腹膜层，并在右壁腹膜上作10条2至3cm长的纵切口。用4/0无创伤连续尼龙缝线关闭腹壁。第一组为对照组，第二组给予10mg/kg盐酸苯海拉明，第三组给予100mg/kg奈多罗米钠，第四组给予上述剂量的两种药物。除奈多罗米钠在手术前30分钟和腹壁关闭后分别给予两次单独剂量外，所有药物均在腹壁关闭后注入腹腔。初次手术后2周进行再次剖腹手术并对腹部粘连进行评分。采用Kruskal-Wallis和Mann-Whitney U检验进行统计学评估。
第一、二、三、四组粘连评分的平均值±标准差（中位数）分别为2.5±0.90（2.0）、1.58±0.99（1.0）、0.92±0.86（1.0）和1.75±0.75（2.0）。第一组与第二组（P = 0.033）、第一组与第三组（P < 0.001）以及第一组与第四组（P = 0.033）的评分之间存在显著差异。
在我们的研究中，盐酸苯海拉明和奈多罗米钠均可单独或联合减少术后腹部粘连。给予奈多罗米钠的组粘连形成的平均评分最低。为了发现这些药物作为人类抗粘连剂的任何积极作用，还需要更多的研究。
