Okino M, Tomie H, Kanesada H, Marumoto M, Morita N, Esato K
First Department of Surgery, Yamaguchi University School of Medicine, Ube, Japan.
Nihon Geka Gakkai Zasshi. 1991 Apr;92(4):381-6.
The correlation between the dose of menatetrenone and the incidence of post-laparotomy peritoneal adhesion in Ryan's model was investigated with the use of rats. In the menatetrenone treated group, the menatetrenone was intramuscularly given in a dosage of 10 mg immediately after closure of the abdominal wound and every 24 hours for two days. In this group, the incidence of ceco-colonic adhesion was 54% (20/37), whereas the incidence in non-treated group was 26% (10/39) (p less than 0.012). Especially in cases with an air-drying time of 1-2 minutes, the difference between incidences of ceco-colonic adhesion in the menatetrenone and that of the non-treated group was high. The former incidence was 61% (17/28) and that of the latter was 21% (6/29) (p less than 0.01). In addition, the incidence of peritoneal adhesion was proportionally dose-dependent to the menatetrenone. In our clinical retrospective study, the incidence of post-gastrectomy adhesive ileus increased with menatetrenone treatment to a significant degree. It is concluded that prophylactic administration of a large dose of menatetrenone should be avoided, because the incidence of post-laparotomy peritoneal adhesion could be increased.
采用大鼠研究了维生素K4剂量与Ryan模型中剖腹术后腹膜粘连发生率之间的相关性。在维生素K4治疗组中，腹部伤口闭合后立即肌肉注射10mg维生素K4，每24小时注射一次，共注射两天。该组盲肠-结肠粘连发生率为54%（20/37），而未治疗组的发生率为26%（10/39）（p<0.012）。特别是在空气干燥时间为1 - 2分钟的情况下，维生素K4治疗组和未治疗组的盲肠-结肠粘连发生率差异很大。前者发生率为61%（17/28），后者为21%（6/29）（p<0.01）。此外，腹膜粘连的发生率与维生素K4剂量呈正比。在我们的临床回顾性研究中，胃切除术后粘连性肠梗阻的发生率在接受维生素K4治疗后显著增加。得出的结论是，应避免大剂量预防性使用维生素K4，因为这可能会增加剖腹术后腹膜粘连的发生率。
