Shushan A, Mor-Yosef S, Avgar A, Laufer N
Department of Obstetrics and Gynecology, Hadassah Medical Center, Hebrew University, Jerusalem, Israel.
J Reprod Med. 1994 May;39(5):398-402.
Adhesions, which form in > 60% of patients following major abdominopelvic surgery, are a common cause of morbidity and infertility in women. Hyaluronic acid is a naturally occurring polysaccharide that has been shown to be beneficial in ophthalmic surgery and as intraarticular injections. This study was designed to examine the use of hyaluronic acid as an agent for adhesion prevention after experimental abrasion of rat uterine horns and to explore its possible mechanism of action. Twenty-nine female Sabra rats were randomly assigned to either a saline (n = 13) or hyaluronic acid (n = 16) group. Adhesions were created by local abrasion of the uterine surfaces. Five milliliters of 1% hyaluronic acid or saline was instilled intraperitoneally. Three weeks later the animals were killed and subjected to a second laparotomy. Intraabdominal adhesions were graded on the basis of gross appearance using a scoring system from 0 to 5. The adhesion score in the animals treated with hyaluronic acid was significantly (P < .001) lower than that in the control animals. Hyaluronic acid did not affect the attachment or proliferation of fibroblasts but had an inhibitory effect on platelet aggregation in a dose-dependent manner. Intraperitoneal instillation of 1% hyaluronic acid significantly minimized adhesions formed experimentally. The mechanism of action may involve inhibition of platelet aggregation.
粘连在接受大型腹部盆腔手术后的患者中发生率超过60%，是女性发病和不孕的常见原因。透明质酸是一种天然存在的多糖，已被证明在眼科手术和关节腔内注射中有益。本研究旨在探讨透明质酸作为预防大鼠子宫角实验性磨损后粘连的药物的用途，并探索其可能的作用机制。29只雌性Sabra大鼠被随机分为生理盐水组（n = 13）或透明质酸组（n = 16）。通过局部磨损子宫表面造成粘连。将5毫升1%的透明质酸或生理盐水腹腔内注入。三周后处死动物并进行第二次剖腹手术。根据大体外观使用0至5分的评分系统对腹腔内粘连进行分级。用透明质酸治疗的动物的粘连评分显著低于对照动物（P <.001）。透明质酸不影响成纤维细胞的附着或增殖，但对血小板聚集有剂量依赖性抑制作用。腹腔内注入1%的透明质酸可显著减少实验性形成的粘连。其作用机制可能涉及抑制血小板聚集。
