医用粘多糖凝胶预防妇科术后腹盆腔粘连的动物实验研究

目的：探讨几丁糖衍生物对妇科术后腹盆腔粘连的预防作用和机制。方法：将50只雌性新西兰大白兔随机分为对照组和实验组，在肠管、子宫、输卵管浆膜人为制造创伤，实验组以几丁糖衍生物防粘液涂抹创面，对照组不处理。分别于术后1、2、4、8、12周肉眼观察两组粘连情况，并进行病理学形态的观察。结果：统计学结果显示术后第2、4、8、12周两组粘连等级比较差异均有显著性（P〈0．01）。光镜下实验组炎症反应轻微，成纤维细胞增生不明显，间皮细胞增生活跃；电镜下实验组纤维细胞较小，细胞器不发达，间皮细胞细胞器发达。结论：几丁糖衍生物可促进内皮细胞生长，抑制成纤维细胞生长，减少胶原纤维的合成；有效地降低大白兔术后腹腔粘连的发生，减轻粘连程度。

Experimental Research of Derivative Chitosan on the Prevention of Post-Surgical Pelvic and Abdominal Adhesions in Gynecology

Objective:To explore the effect of derivative chitosan on the prevention of post-surgical pelvic and abdominal adhesion in gynecology.Methods:50 female white rabbits were assigned into control group and experimental group randomly.Serosal injury of intestine,uterus,oviduct was made factitiously,and derivative chitosan agent was spread on the region of serosal injury of experimental group.The adhesive degree was observed and samples was taken at the 1,2,4,8,12 postoperative week respectively.Result:There were statistically significant differences of the degree of adhesions between the two groups at the 2,4,8,12 postoperative week(P<0.01);Mild inflammatory changes and less fibrous proliferation were observed in experimental group microscopically;Decreased proliferation of fibroblast and active proliferation of mesothelial cell were observed in experimental group under electron microscopy.Conclusions:the incidence and degree of post-surgical adhesion in gynecology could be effectively reduced by derivative chitosan.