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富血小板血浆对术后腹膜炎症和粘连的影响。

Effect of platelet-rich plasma on postoperative peritoneal inflammation and adhesions.

作者信息

Karakaş Dursun Özgür, Dandin Özgür, Müftüoğlu Tuba, Tihan Deniz, Bal Ahmet Selim, Yıldırım Şükrü

机构信息

Department of General Surgery, Okmeydanı Training and Research Hospital, Istanbul, Turkey.

Department of General Surgery, Trabzon Training and Research Hospital, Trabzon, Turkey.

出版信息

Arch Med Sci. 2020 Apr 18;17(5):1408-1413. doi: 10.5114/aoms.2020.94538. eCollection 2021.

Abstract

INTRODUCTION

Postoperative peritoneal adhesion is an important complication of abdominopelvic surgery. The aim of this study is to reveal the effect of platelet-rich plasma (PRP) on postoperative intraperitoneal inflammation and adhesions.

MATERIAL AND METHODS

Twenty-four Wistar albino rats were divided into three groups. Cecal incision and suturation was carried out for the experimental model. Intraperitoneally, 3 ml of 0.9% NaCl, 3 ml of PRP, and nothing were applied, and called as saline, PRP, and control groups, respectively. Four subjects in each group were sacrificed at the 3 and 7 days postoperatively. Adhesion formations and giant cell, lymphocyte/plasmocyte, neutrophil, and histiocyte counts were assessed and hydroxyproline levels were measured in all groups and statistical comparisons were performed.

RESULTS

Except giant cell 3 day scores, PRP had the lowest adhesion, neutrophil, lymphocyte, plasmocyte, histiocyte and fibrosis scores. Both 3 and 7 days scores of giant cell, neutrophil, lymphocyte, plasmocyte, but only 7 days scores of histiocyte reaction and fibrosis were statistically significant ( < 0.05). Hydroxyproline levels were lower in the saline group at the 3 day. However, at the 7 day, the levels were lower in the PRP group and no statistically significant difference was found compared to the saline group 3 day levels ( > 0.05).

CONCLUSIONS

Platelet-rich plasma has a reducing effect on the postoperative peritoneal adhesions with separation of the damaged tissues, affecting the inflammation, matrix metalloproteinase, plasminogen activation or the other stages of adhesion formation.

摘要

引言

术后腹膜粘连是腹部盆腔手术的一种重要并发症。本研究旨在揭示富血小板血浆(PRP)对术后腹腔内炎症和粘连的影响。

材料与方法

将24只Wistar白化大鼠分为三组。采用盲肠切开并缝合建立实验模型。分别向腹腔内注入3 ml 0.9%氯化钠溶液、3 ml PRP以及不做处理,依次称为生理盐水组、PRP组和对照组。每组分别于术后第3天和第7天处死4只大鼠。评估所有组的粘连形成情况以及巨细胞、淋巴细胞/浆细胞、中性粒细胞和组织细胞计数,并测量羟脯氨酸水平,进行统计学比较。

结果

除巨细胞3天评分外,PRP组的粘连、中性粒细胞、淋巴细胞、浆细胞、组织细胞和纤维化评分最低。巨细胞、中性粒细胞、淋巴细胞、浆细胞的3天和7天评分,以及仅组织细胞反应和纤维化的7天评分差异具有统计学意义(P<0.05)。生理盐水组第3天的羟脯氨酸水平较低。然而,第7天时,PRP组的水平较低,与生理盐水组第3天的水平相比无统计学差异(P>0.05)。

结论

富血小板血浆对术后腹膜粘连具有减轻作用,可分离受损组织,影响炎症、基质金属蛋白酶、纤溶酶原激活或粘连形成的其他阶段。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/df8e/8425244/3c0c17debabe/AMS-17-5-99249-g001.jpg

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