术后肠粘连与肿瘤生长转移的相关性及PDLLA干预的实验研究

目的研究腹部手术后肠粘连和肿瘤生长、转移间的相关性,并探讨可降解聚-DL-乳酸可吸收医用膜（PDLLA）的治疗效果.方法雄性Wistar大鼠60只分为肿瘤移植组（A组）和非肿瘤移植组（B组）.A、B两组又分为肠粘连模型、PDLLA治疗和假手术组,分别行手术,术后4周用半定量方法对肠粘连形成和肿瘤生长、转移情况进行评分.结果术后4周肿瘤移植组各亚组的肿瘤生长、转移和肠粘连评分均大于非肿瘤移植组（P＜0.05）,肠粘连模型组的肿瘤生长、转移和肠粘连评分均高于PDLLA干预组（P＜0.05）.术后肠粘连的形成及严重程度与肿瘤生长、转移呈正相关（P＜0.05）;PDLLA干预和术后肠粘连、肿瘤生长和转移评分呈负相关（P＜0.05）.结论PDLLA在减少术后肠粘连形成的同时有可能同时减少与肠粘连相关的肿瘤生长和转移.

The correlation between postoperative intraabdominal adhesions and tumor growth/metastasis and the effect of PDLLA

Objective To investigate the correlation between postoperative intraabdominal adhesions and tumor growth and metastasis and to evaluate the effect of PDLLA. Methods Sixty male Wistar rats were divided into tumor transplantation group ( A group) and non-tumor-transplantation group (B group). Both groups were further subdivided into intraabdominal adhesion model subgroup, PDLLA intervention subgroup and false operation subgroup respectively. Postoperative intraabdominal adhesions and tumor growth and metastasis were semiquantitively scored 4 weeks after the operation. Results The scores of intraabdominal adhesion and the tumor growth and metastasis in all subgroups of tumor transplantation group were higher than that of non-tumor-transplantation group ( P < 0. 05 ) ; the scores of intraabdominal adhesion and the tumor growth and metastasis in intraabdominal adhesion model groups were higher than PDLLA intervention group ( P < 0. 05 ). There was a positive correlation between postoperative intestinal adhesions and growth/metastasis of tumor ( P < 0. 05 ). A negative correlation between PDLLA intervention and the degree of adhesions and the tumor growth/metastasis (P <0. 05) was found. Conclusion PDLLA reduces the degree of postoperative intraabdominal adhesions, hence reduces adhesion-related tumor growth and metastasis.