Shyr Y M, Su C H, Wang H C, Lo S S, Lui W Y
Department of Surgery, Veterans General Hospital, Taipei, Taiwan, Republic of China.
Am Surg. 1995 Mar;61(3):265-70.
Reproducibility of the so-called "mucolytic effect" of the 2%-10% dextrose-water solution is questioned. To test the mucolytic effect of 5% and 10% dextrose-water solutions and to determine what could be a true mucolytic agent, in vitro and in vivo studies were undertaken in two proven pseudomyxoma peritonei cases. In vitro study: Immediately after the mucin jelly was taken out of the peritoneal cavity, the jelly was immersed in various 40 cc solutions including: 1) 5% dextrose-water; 2) 10% dextrose-water; 3) normal saline; 4) lactated Ringer; 5) distilled water. The mucolytic effects of these solutions were observed once every hour after vigorous mixing. In vivo study: After completion of the operation, the peritoneal cavity was repeatedly irrigated with massive warm 5% dextrose-water and normal saline solutions in an attempt to dissolve the residual mucin cake and jelly. Neither 5% and 10% dextrose-water solution nor control solutions of normal saline, lactated Ringer, and distilled water could dissolve the mucin jelly in test tubes at 0, 1, 2, and 3 hours. The "claimed" mucolytic agent, 5% dextrose-water solution could not facilitate the removal of both mucin jelly and cake in the peritoneal cavity. The 5% dextrose-water solution was not superior to the normal saline solution in terms of mucolytic effect. In the present study, a true mucolytic agent does not exist. Currently, multiple laparotomy for aggressive cytoreduction remains the treatment of choice for pseudomyxoma peritonei.
2%-10%葡萄糖水溶液所谓的“黏液溶解作用”的可重复性受到质疑。为了测试5%和10%葡萄糖水溶液的黏液溶解作用，并确定真正的黏液溶解剂可能是什么，我们对两例经证实的腹膜假黏液瘤病例进行了体外和体内研究。体外研究：将黏液冻胶从腹腔取出后，立即将其浸入各种40毫升溶液中，包括：1）5%葡萄糖水溶液；2）10%葡萄糖水溶液；3）生理盐水；4）乳酸林格液；5）蒸馏水。剧烈混合后，每小时观察一次这些溶液的黏液溶解作用。体内研究：手术完成后，用大量温热的5%葡萄糖水溶液和生理盐水反复冲洗腹腔，试图溶解残留的黏液饼和冻胶。在0、1、2和3小时时，5%和10%葡萄糖水溶液以及生理盐水、乳酸林格液和蒸馏水的对照溶液均不能在试管中溶解黏液冻胶。所谓的黏液溶解剂5%葡萄糖水溶液并不能促进腹腔内黏液冻胶和黏液饼的清除。在黏液溶解作用方面，5%葡萄糖水溶液并不优于生理盐水溶液。在本研究中，不存在真正的黏液溶解剂。目前，积极的细胞减灭术多次剖腹手术仍然是腹膜假黏液瘤的首选治疗方法。
