Lai H S, Chu S Y, Chen Y, Wu C H, Lin L T
Department of Surgery, National Taiwan University Hospital, Taipei, R.O.C.
J Formos Med Assoc. 1994 Nov-Dec;93(11-12):911-5.
Pentoxifylline, an analogue of the methylxanthine theobromine, inhibits glycosaminoglycan and collagen synthesis by dermal fibroblasts in vitro and also inhibits the proliferation of dermal fibroblasts. It may have the same effect on fibroblasts derived from postoperative adhesion bands, thus preventing postoperative adhesion formation. An animal model was developed to evaluate the effect of pentoxifylline. Twenty-four male Wistar rats were divided into four groups, and all underwent laparotomy with a 15 cm intestinal resection and reanastomosis. The intestinal serosa was scratched to induce adhesion formation. No medication was given in group 1 rats, group 2 rats received 6 mL normal saline by intraoperative peritoneal irrigation, group 3 rats received 6 mL pentoxifylline solution (1 mg/mL) by intraperitoneal irrigation and group 4 rats received both 6 mL intraoperative pentoxifylline solution (1 mg/mL) irrigation and 50 mg/kg pentoxifylline by intramuscular injection, twice a day for 14 days. All rats were sacrificed 2 weeks later. The numbers of fibrous bands at and away from the anastomotic site were recorded and scored. The score for each rat was calculated as the sum of the scores for each band. The strength and the extent of the fibrous bands were also measured and compared. The scores of adhesion bands at the anastomotic site were significantly reduced in group 3 and group 4 rats when compared with group 1 rats. However, there were no significant differences among the 4 groups in the extent and strength of adhesions at sites other than the anastomosis site.
己酮可可碱是甲基黄嘌呤可可碱的类似物,在体外可抑制真皮成纤维细胞合成糖胺聚糖和胶原蛋白,还可抑制真皮成纤维细胞的增殖。它可能对术后粘连条索来源的成纤维细胞有同样的作用,从而预防术后粘连形成。本研究建立了动物模型来评估己酮可可碱的作用。将24只雄性Wistar大鼠分为四组,所有大鼠均接受剖腹手术,切除15 cm肠段并进行肠吻合术。刮伤肠浆膜以诱导粘连形成。第1组大鼠不给予药物治疗,第2组大鼠术中经腹腔冲洗给予6 mL生理盐水,第3组大鼠经腹腔冲洗给予6 mL己酮可可碱溶液(1 mg/mL),第4组大鼠术中经腹腔冲洗给予6 mL己酮可可碱溶液(1 mg/mL),并肌肉注射50 mg/kg己酮可可碱,每天两次,共14天。2周后处死所有大鼠。记录并评分吻合部位及吻合部位以外的纤维条索数量。每只大鼠的评分计算为每条纤维条索评分的总和。还测量并比较了纤维条索的强度和范围。与第1组大鼠相比,第3组和第4组大鼠吻合部位粘连条索的评分显著降低。然而,在吻合部位以外的部位,四组之间粘连的范围和强度没有显著差异。