Gehlbach D L, O'Hair K C, Parks A L, Rosa C
Department of Obstetrics and Gynecology, William Beaumont Army Medical Center, El Paso, Texas.
Int J Fertil Menopausal Stud. 1994 May-Jun;39(3):172-6.
To test the effectiveness, in combination, of recombinant tissue plasminogen activator (rt-PA) and carboxymethylcellulose (CMC), which have both been investigated as adjuncts in the prevention of postsurgical adhesion reformation.
A total of 45 mature New Zealand rabbits underwent laparotomy and bilateral uterine horn abrasion using a scalpel for scarification. Adhesions were scored according to the extent of uterine horn involvement and quality of the adhesions. Three weeks later, after the adhesions were scored and lysed using microsurgical technique, the animals were randomized to receive 20 mL of one of four adjunctive treatments: (1) abnormal saline; (2) 2% sodium CMC, (3) 10 mg rt-PA mixed in 2% sodium CMC, or (4) 32% dextran 70. The adhesions were scored again 3 weeks later at necropsy.
Although adhesion scores decreased slightly in all groups, there was no statistically significant difference in adhesion reformation between the four groups. Four rabbits died of intra-abdominal hemorrhage following lysis of adhesions, including three in the rt-PA/CMC group. The combination of intraperitoneal rt-PA and CMC did not reduce postsurgical adhesion reformation, and was associated with hemorrhagic complications.
测试重组组织型纤溶酶原激活剂（rt-PA）和羧甲基纤维素（CMC）联合使用的有效性，这两种物质都已被研究作为预防术后粘连再形成的辅助剂。
总共45只成年新西兰兔接受剖腹手术，并用手术刀对双侧子宫角进行划痕以形成瘢痕。根据子宫角受累程度和粘连质量对粘连进行评分。三周后，在对粘连进行评分并用显微外科技术松解后，将动物随机分为四组接受以下四种辅助治疗之一：（1）生理盐水；（2）2%羧甲基纤维素钠；（3）10毫克rt-PA与2%羧甲基纤维素钠混合；或（4）32%右旋糖酐70。三周后在尸检时再次对粘连进行评分。
虽然所有组的粘连评分均略有下降，但四组之间在粘连再形成方面没有统计学上的显著差异。四只兔子在粘连松解后死于腹腔内出血，其中三只在rt-PA/CMC组。腹腔内rt-PA和CMC联合使用并不能减少术后粘连再形成，且与出血并发症相关。
