大网膜防止聚丙烯网片与腹腔脏器粘连的实验研究

目的:探讨大网膜防止聚丙烯网片与腹腔脏器粘连的作用及其丧失保护作用的原因。方法:1.动物实验:将雄性Wistar大鼠分为5组:(A)大网膜复盖组(n=15);(B)无大网膜复盖组(n=15);(C)大网膜切除组(n=15);(D)大网复盖 伤口葡萄球菌种植组(n=15);(E)大网膜切除组 伤口葡萄球菌种植组(n=15)。结果:D、E组动物术后死亡率明显高于A、B、C组(P<0.05)。术后1个月,D和E组粘连评分明显高于A、B、C组(P<0.05),术后2个月和3个月各组间粘连评分无显著性差别(P>0.05),但A和B组均为网膜与网片粘连,而D和E组则主要为肠管或肝脏参与粘连,C组为部分肠管或肝脏与网片粘连。结论:在无感染情况下大网膜具有防止腹腔脏器与网片粘连的作用,而感染后大网膜则失去保护作用,同样发生网片与腹腔脏器间的严重粘连。

Omentum as a intermediate layer in preventing adhesion between abdominal viscera and polypropylene mesh(an experimental study)

Objective To investigate the effect of the omentum in preventing adhesion between the polypropylene mesh and abdominal viscera. Methods Male Wistar rats were assigned into omentum covering group( Group A, n=15), no omentum covering group(Group B, n=15), omentum resected group(Group C, n=15), omentum covering plus staphylococcus implantation group(group D, n=15), omentum resected plus staphylococcus implantation group (Group E, n=15). Results The mortality in Groups D and E was significantly higher than that in Groups A, B and C postoperatively(P<0.05).The score in adhesion formation Groups D and E was remarkably higher in Groups A, B and C one month after operation(P<0.05), while no notable difference was observed 2 and 3 months after operation(P<0.05), only adhesion of the omentum to the mesh was observed in all animals of Groups A and B, but adhesion of the bowel or the liver to the mesh in Groups D and E, partial adhesion of the bowel and liver to the mesh in Group C. Conclusions The omentum can pretect abdominal viscera from adhering to the mesh in the absence of infection, but this effect of protection was lost in the presence of infection.