首页|聚乙醇酸与羟丙基甲基纤维素用于远端胰腺切除模型术后缝合的有效性和安全性评估

聚乙醇酸与羟丙基甲基纤维素用于远端胰腺切除模型术后缝合的有效性和安全性评估

扫码查看
目的 探讨应用聚乙醇酸(polyglycolic acid,PGA)与羟丙基甲基纤维素(hydroxypropyl methylcellulose,HPMC)复合材料在远端胰腺切除术后缝合中的有效性和安全性.方法 选用36只健康成年比格犬,将其随机均分为观察组和对照组,每组各18只行远端胰腺切除手术.观察组实验犬使用PGA+HPMC复合材料进行切口加固;对照组实验犬使用NEOVEIL进行切口加固.术前、术后3 d及解剖前,分别对各组实验犬进行血常规检测.设置2周、4周、8周观察周期,每个观察点各6只动物进行心肝脾肺肾组织学检查、硬组织切片病理诊断等评估,并进行安全性评价.结果 观察组和对照组实验犬在术前血常规检测比较差异无统计学意义.重复测量方差分析结果显示,不同时间点的白细胞计数(WBC)(F=14.875,P=0.001)、平均红细胞血红蛋白浓度(MCHC)(F=5.049,P=0.009)、中性粒细胞百分比(Neu%)(F=4.794,P=0.011)、红细胞计数(RBC)(F=6.591,P=0.002)、血红蛋白(HGB)(F=8.154,P=0.001)、红细胞比容(HCT)(F=5.281,P=0.007)、血小板计数(PLT)(F=6.560,P=0.014)、红细胞分布宽度变异系数(RDW-CV)(F=33.950,P=0.039)、淋巴细胞百分比(Lym%)(F=3.299,P=0.043)均值存在差异,但观察组和对照组组间无统计学差异,且时间与组别交互作用对其无显著影响,表明两组实验犬均出现了炎症反应或手术应激.两组实验犬在术后8周的硬组织病理切片评分中,观察组和对照组实验犬的炎症与坏死相关评分、纤维化、修复等相关评分和总分方面差异均无统计学意义(P>0.05).两组实验犬在术后8周的解剖中,均未发现心肝脾肺肾等器官有明显的损伤,也未发现缝合材料残留、胰液渗漏或胰瘘等情况,表明两组缝合材料均已完全被吸收代谢,且切口愈合良好不会对内脏器官造成不良影响.结论 PGA与HPMC是一种有效和安全的术后缝合材料,具有良好的生物可降解性、生物相容性、缝合强度和创面愈合质量,可以在远端胰腺切除术后缝合中与传统的可吸收性加固材料相媲美,为其在临床上的应用提供了科学依据.
Efficacy and safety assessment of polyglycolic acid and hydroxypropyl methylcellulose for postoperative suturing in a distal pancreatectomy model
Objective To explore the effectiveness and safety of polyglycolic acid(PGA)and hydroxypropyl methylcellulose(HPMC)composite materials in distal pancreatectomy postoperative suturing.Methods We selected 36 healthy adult beagles and divided them randomly into observation group and control group,with 18 distal pancreatectomy surgeries in each group.The observation group used PGA+HPMC composite materials for incision reinforcement while the control group used NEOVEIL for incision reinforcement.3 days before surgery,3 days after surgery,and before dissection,blood routine tests were performed on each group of experimental dogs.Observation periods of 2-week,4-week and 8-week were set,and six animals at each observation point were evaluated for histological examination of heart,liver,spleen,lung,and kidney tissues,hard tissue slice pathological diagnosis,and safety evaluation.Results There was no significant difference between the observation group and the control group in the preoperative blood routine test.Repeated measures ANOVA results showed differences in the mean values of white blood cell count(WBC)(F=14.875,P=0.001),mean corpuscular hemoglobin concentration(MCHC)(F=5.049,P=0.009),neutrophil percentage(Neu%)(F=4.794,P=0.011),red blood cell count(RBC)(F=6.591,P=0.002),hemoglobin(HGB)(F=8.154,P=0.001),hematocrit(HCT)(F=5.281,P=0.007),platelet count(PLT)(F=6.560,P=0.014),red blood cell distribution width coefficient of variation(RDW-CV)(F=33.950,P=0.039),or lymphocyte percentage(Lym%)(F=3.299,P=0.043)at different time points.However,the observation group and the control group did not differ,and the interaction between time and group had no significant effect on the above indicators,suggesting that both groups of dogs had inflammatory response or surgical stress.For the 8-week postoperative hard tissue pathological section score,there was no significant difference between the observation group and the control group in the inflammation and necrosis related score,fibrosis,repair or other related scores and total score(P>0.05).In the dissection at 8 weeks after surgery,no obvious damage to the heart,liver,spleen,lung,kidney,or other organs was found in both groups,nor was there any residual suture material,pancreatic fistula,or pancreatitis,indicating that the suture materials in both groups had been completely absorbed and metabolized,and the incision healed well without causing adverse effects on the visceral organs.Conclusion PGA and HPMC are effective and safe postoperative suture materials,with good biodegradability,biocompatibility,suture strength,and wound healing quality.They can be comparable to traditional absorbable reinforcement materials in distal pancreatectomy postoperative suturing,thus providing scientific basis for their clinical application.

polyglycolic acid(PGA)hydroxypropyl methyl cellulose(HPMC)biological materialpostoperative suturingsafety assessment

陈俊凯、丁榆、王宝枝、松谷哲行、杨学伟、张风华

展开 >

广州医科大学附属第二医院番禺院区普外科,广东广州 511440

帝京大学医学部附属沟口医院呼吸外科,日本东京都 213-8507

广州医科大学附属第二医院肝胆外科,广东广州 511440

聚乙醇酸(PGA) 羟丙基甲基纤维素(HPMC) 生物材料 术后缝合 安全性评估

国家自然科学基金面上项目

82273087

2024

西安交通大学学报(医学版)
西安交通大学

西安交通大学学报(医学版)

CSTPCD北大核心
影响因子:1.144
ISSN:1671-8259
年,卷(期):2024.45(2)
  • 20