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[术后腹腔内粘连——一种新的标准化客观动物模型及预防粘连物质的测试]

[Postoperative, intra-abdominal adhesions--a new standardized and objective animal model and testing of substances for the prevention of adhesions].

作者信息

Treutner K H, Winkeltau G, Lerch M M, Stadel R, Schumpelick V

机构信息

Chirurgische Klinik, Medizinischen Fakultät, Rheinisch-Westfalischen Technischen Hochschule Aachen.

出版信息

Langenbecks Arch Chir. 1989;374(2):99-104. doi: 10.1007/BF01261618.

Abstract

80 male Sprague Dawley rats were divided in 8 groups of equal size. After median laparotomy defined abrasions of the serosa of abdominal wall, cecum and ileum were performed (400p, abrasive paper 280 grains/cm2, 8 cm2). The control group (I) received no medication. In the treatment groups 5 ml of the following agents were instilled before closure of the abdominal wall: normal saline (II), 16,250 IE Neomycin with 1250 IE Bacitracin (III), 30% dextrose (MW 70,000) (IV), 50,000 IE Streptokinase with 12,500 IE Streptodornase (V), or TCDO in concentrations of 10% (VI), 50% (VII), and 100% (VIII). All animals were relaparotomized on the 7th postoperative day, the adhesions were dissected and their extent was calculated by computer aid. Furthermore specimens were obtained for microscopic studies. Compared to the controls no reduction of adhesions could be achieved by dextrose. Significantly more adhesions were observed after treatment with Neomycin/Bacitracin. A reduction of about 23% was registered with normal saline and TCDO 10%. The greatest reduction of adhesions was seen after application of Streptokinase/Streptodornase as well as TCDO in concentrations of 50% and 100% (63%). The results were significant after evaluation with the t-test. Histologically there was a correlation between the extent of adhesions and the fibrin film. The new animal model has proven to result in reproducible data if used to evaluate substances for prevention of adhesions. Clinical studies with the best of these agents could serve as an approach to solve the problem of adhesion ileus.

摘要

80只雄性斯普拉格-道利大鼠被平均分为8组。经正中剖腹术后,用砂纸(400目,280粒/平方厘米,8平方厘米)对腹壁、盲肠和回肠的浆膜进行擦伤处理。对照组(I组)不给予药物治疗。在治疗组中,于关闭腹壁前向腹腔内注入5毫升以下药物:生理盐水(II组)、含1250国际单位杆菌肽的16250国际单位新霉素(III组)、30%葡萄糖(分子量70000)(IV组)、含12500国际单位链道酶的50000国际单位链激酶(V组),或浓度为10%(VI组)、50%(VII组)和100%(VIII组)的TCDO。所有动物在术后第7天再次剖腹,分离粘连组织,并通过计算机辅助计算粘连范围。此外,还获取标本进行显微镜检查。与对照组相比,葡萄糖未能减少粘连。新霉素/杆菌肽治疗后观察到的粘连明显增多。生理盐水和10%的TCDO治疗后粘连减少约23%。应用链激酶/链道酶以及50%和100%浓度的TCDO后粘连减少最为显著(63%)。经t检验评估,结果具有显著性差异。组织学上,粘连程度与纤维蛋白膜之间存在相关性。如果用于评估预防粘连的物质,这种新的动物模型已被证明能产生可重复的数据。对这些最佳药物进行临床研究可能是解决粘连性肠梗阻问题的一种方法。

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