目的 观察改性壳聚糖防粘连膜对心肌梗死兔心脏与周围组织粘连程度的影响.方法 25只日本长耳白兔,开胸结扎冠状动脉制备心肌梗死模型,随机分为对照组(A组)和改性壳聚糖防粘连膜组(B组),A组正常关胸,B组关胸前在心脏和胸壁间置入改性壳聚糖防粘连膜.每组造模型成功各11只.术后3个月A组存活8只、B组存活9只.分别行在体磁共振电影和二次开胸,分级评价粘连程度.采用Wilcoxon秩和检验.结果 磁共振电影评价粘连程度,A组轻度粘连、中度粘连、重度粘连分别为2只、2只、4只;B组分别为7只、2只、0只.差异有统计学意义(P〈0.05).开胸评价粘连程度,A组无粘连、轻度粘连、中度粘连、重度粘连分别为1、1、2、4只;B组分别为3、4、2、0只.差异有统计学意义(P〈0.05).结论 改性壳聚糖防粘连膜可以减轻心肌梗死模型兔心脏与周围组织粘连.
Objective To evaluate the efficacy of a chemically modified chitosan anti-adhesion membrane for preventing postoperative pericardial adhesions in rabbit myocardial infarction model. Methods Twenty-five Japanese white rabbits underwent myocardial infarction by ligation of coronary artery after thoracotomy, and devided into treatment and control groups randomly. The treatment group had a chitosan anti-adhesion membrane placed between the heart and retrostemal injured surfaces, while control group received nothing. Then Chest was subsequently closed. Eleven rabbits survived the operation in each group. After a period of 3 months, there were 8 rabbits alive in control group and 9 rabbits alive in treatment group. The animals were examined by Cine magnetic resonance imaging. sacrificed under anesthesia, and independent observers, blinded to treatment, graded the formation of pericardial adhesions by magnetic resonance cinema and histologioal anatomy respectively. Data were analyzed by Wilcoxon' s rank test. Results Cine magnetic resonance imaging revealed that there were 2,2,4 cases of mild adhesion, moderate adhesion,and severe adhesion in group, and 7, 2, 0 respectively (P〈0.05). Thoracotomy indicated there were 1,1,2,4 cases of adhesions, mild adhesions, moderate adhesions, and severe adhesions in group A, and 3, 4, 2, 0 in group B respectively (P 〈 0. 05). Conclusion Placement of a chemically modified chitosan anti-adhesion membrane between injured surfaces effectively reduced the formation of postoperative pericardial adhesion in rabbits of myocardial infarction model.