Kang Hyun, Chung Yoon Sang, Kim Sang Wook, Choi Geun Joo, Kim Beom Gyu, Park Suk Won, Seok Ju Won, Hong Joonhwa
Department of Anesthesiology and Pain Medicine, Chung-Ang University College of Medicine, Seoul, Korea.
Department of Thoracic and Cardiovascular Surgery, Chung-Ang University College of Medicine, Seoul, Korea.
PLoS One. 2015 Nov 18;10(11):e0143359. doi: 10.1371/journal.pone.0143359. eCollection 2015.
We investigated the mobility of a temperature-sensitive poloxamer/Alginate/CaCl2 mixture (PACM) in relation to gravity and cardiac motion and the efficacy of PACM on the prevention of pericardial adhesion in a supine rabbit model.
A total of 50 rabbits were randomly divided into two groups according to materials applied after epicardial abrasion: PACM and dye mixture (group PD; n = 25) and saline as the control group (group CO; n = 25). In group PD, rabbits were maintained in a supine position with appropriate sedation, and location of mixture of PACM and dye was assessed by CT scan at the immediate postoperative period and 12 hours after surgery. The grade of adhesions was evaluated macroscopically and microscopically two weeks after surgery.
In group PD, enhancement was localized in the anterior pericardial space, where PACM and dye mixture was applied, on immediate post-surgical CT scans. However, the volume of the enhancement was significantly decreased at the anterior pericardial space 12 hours later (P < .001). Two weeks after surgery, group PD had significantly lower macroscopic adhesion score (P = .002) and fibrosis score (P = .018) than did group CO. Inflammation score and expression of anti-macrophage antibody in group PD were lower than those in group CO, although the differences were not significant.
In a supine rabbit model study, the anti-adhesion effect was maintained at the area of PACM application, although PACM shifted with gravity and heart motion. For more potent pericardial adhesion prevention, further research and development on the maintenance of anti-adhesion material position are required.
我们研究了温度敏感型泊洛沙姆/海藻酸盐/氯化钙混合物（PACM）在重力和心脏运动影响下的移动情况，以及该混合物在仰卧位兔模型中预防心包粘连的效果。
总共50只兔子根据心外膜擦伤后应用的材料随机分为两组：PACM与染料混合物组（PD组；n = 25）和生理盐水作为对照组（CO组；n = 25）。在PD组中，兔子在适当镇静下保持仰卧位，术后即刻和术后12小时通过CT扫描评估PACM与染料混合物的位置。术后两周通过宏观和微观评估粘连等级。
在PD组中，术后即刻CT扫描显示增强区域位于应用PACM与染料混合物的心包前间隙。然而，12小时后心包前间隙的增强体积显著减小（P <.001）。术后两周，PD组的宏观粘连评分（P =.002）和纤维化评分（P =.018）显著低于CO组。PD组的炎症评分和抗巨噬细胞抗体表达低于CO组，尽管差异不显著。
在仰卧位兔模型研究中，尽管PACM会随重力和心脏运动移动，但在PACM应用区域仍保持抗粘连效果。为了更有效地预防心包粘连，需要进一步研究和开发维持抗粘连材料位置的方法。
