Department of Gynecology and Obstetrics, Atatürk Education and Research Hospital, Ankara, Turkey.
J Minim Invasive Gynecol. 2013 Mar-Apr;20(2):185-91. doi: 10.1016/j.jmig.2012.11.003. Epub 2013 Jan 5.
To compare the effects of 2 nonsteroidal antiinflammatory drugs of different chemical classes (meloxicam and dexketoprofen) on postoperative intraabdominal adhesion formation in a rat model.
Experimental study (Canadian Task Force classification I).
Center for research and development.
Thirty female Wistar albino rats.
The animals were randomly assigned to 1 of 3 groups (10 rats per group) and received intramuscular injections of 0.5 mg/kg dexketoprofen (group 1), 0.5 mg/kg meloxicam (group 2), or 1 mL sterile saline solution (control; group 3) daily for 2 days. Laparotomy was performed, and 1 of the uterine horns was damaged via monopolar electrocautery, whereas an incision was made in the other horn using a scalpel and was sutured to promote adhesion formation. The surgeons were blinded to the treatment method. Drug administration was continued for 5 days. The animals were euthanized at 14 days after surgery.
Intraperitoneal macroscopic and microscopic adhesions were assessed using standard adhesion scoring systems. Macroscopic adhesion scores were similar among the 3 groups in each horn (p > .50). The total histologic score was significantly lower in the meloxicam group than in the control group (8.0 vs 15.5; p = .006). Dexketoprofen did not significantly affect the total histologic score (11.0 vs 15.5; p = .09) or individual items (i.e., inflammation, fibroblastic activity, foreign body reaction, collagen formation, and vascular proliferation) compared with the control group (p > .02). Meloxicam significantly inhibited inflammation and collagen formation compared with the control group (p < .02). Meloxicam was also significantly superior to dexketoprofen in reducing inflammation (p = .006).
Although meloxicam did not affect clinical adhesion formation, it significantly decreased histologic scores compared with those of the control group. Therefore, meloxicam may be suitable in reducing postoperative intraabdominal adhesion formation.
比较两种不同化学结构类别的非甾体类抗炎药（美洛昔康和右旋酮洛芬）在大鼠模型中对术后腹腔内粘连形成的影响。
实验研究（加拿大任务组分类 I）。
研发中心。
30 只雌性 Wistar 白化大鼠。
动物被随机分为 3 组（每组 10 只），每天接受 0.5mg/kg 右旋酮洛芬（第 1 组）、0.5mg/kg 美洛昔康（第 2 组）或 1mL 无菌生理盐水溶液（对照；第 3 组）的肌肉注射，连续 2 天。进行剖腹术，用单极电灼器损伤 1 个子宫角，用手术刀在另一个子宫角做切口并缝合以促进粘连形成。外科医生对治疗方法不知情。药物治疗持续 5 天。手术后 14 天处死动物。
使用标准粘连评分系统评估腹腔内的宏观和微观粘连。在每个子宫角中，3 组之间的宏观粘连评分相似（p>.50）。美洛昔康组的总组织学评分明显低于对照组（8.0 与 15.5；p=.006）。与对照组相比，右旋酮洛芬对总组织学评分（11.0 与 15.5；p=.09）或单个项目（即炎症、成纤维细胞活性、异物反应、胶原形成和血管增生）均无显著影响（p>.02）。与对照组相比，美洛昔康显著抑制炎症和胶原形成（p<.02）。与右旋酮洛芬相比，美洛昔康在减轻炎症方面也具有显著优势（p=.006）。
尽管美洛昔康对临床粘连形成没有影响，但与对照组相比，它明显降低了组织学评分。因此，美洛昔康可能适合减少术后腹腔内粘连形成。
