Nagelschmidt M, Saad S
Second Department of Surgery, University of Cologne, Germany.
J Surg Res. 1997 Feb 1;67(2):113-8. doi: 10.1006/jsre.1996.4973.
Studies on the prevention of peritoneal adhesions often address the impairment of adhesion formation by a special drug without any attempts to elucidate the working principles. In the present study PEG 4000 was compared with dextran 70 with respect to the influence on adhesion formation, inflammatory reaction, and collagen deposition. Adhesions were created in 30 rats by standardized crushing of the cecum. The animals were randomly allocated to 3 experimental groups receiving an intraabdominal instillation of 5 ml 20% PEG, dextran 70, or 0.9% NaCl. On Day 7 the adhesions were scored; additionally, the amount of leukocytes in the peritoneal cavity and the incorporation of collagen into the adhesion strands were determined. Administration of PEG resulted in a significant reduction of the adhesion score from 10.3 (NaCl) to 2.3, whereas dextran had no effect (score 11.0). This finding correlated with the leukocyte number which was reduced by 44% after PEG but was not affected by dextran. The collagen content of the adhesion strands was significantly decreased by PEG as well as by dextran when compared to the NaCl controls. In our model PEG was highly effective in the impairment of adhesion formation. The positive effect was mediated by a reduction of the inflammatory reaction which resulted in a decreased deposition of collagen into the adhesion strands.
关于预防腹膜粘连的研究通常聚焦于一种特殊药物对粘连形成的抑制作用，而未尝试阐明其作用原理。在本研究中，将聚乙二醇4000（PEG 4000）与右旋糖酐70就其对粘连形成、炎症反应及胶原沉积的影响进行了比较。通过对30只大鼠的盲肠进行标准化挤压来制造粘连。这些动物被随机分为3个实验组，分别腹腔内注入5毫升20%的PEG、右旋糖酐70或0.9%的氯化钠。在第7天对粘连情况进行评分；此外，还测定了腹腔内白细胞数量以及胶原在粘连条索中的掺入情况。给予PEG后粘连评分显著降低，从10.3（氯化钠组）降至2.3，而右旋糖酐则无作用（评分为11.0）。这一发现与白细胞数量相关，PEG处理后白细胞数量减少了44%，而右旋糖酐对此无影响。与氯化钠对照组相比，PEG以及右旋糖酐均使粘连条索中的胶原含量显著降低。在我们的模型中，PEG对粘连形成的抑制作用非常有效。其积极作用是通过减轻炎症反应介导的，炎症反应减轻导致胶原在粘连条索中的沉积减少。
