中国修复重建外科杂志

中国修复重建外科杂志

PLGA/PEG 可吸收电纺聚合膜对大鼠腹腔术后粘连的预防作用研究

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目的采用聚乳酸/乙醇酸共聚物(poly-L-lactic/glycolic acid,PLGA)、聚乙二醇(polyethylene glycol,PEG)以静电纺丝技术制备 PLGA/PEG 可吸收电纺聚合膜,探讨其对大鼠腹腔术后粘连的预防作用。方法将 PLGA 和 PEG 按照 19∶1(M/M)混合后溶解于有机溶剂中,采用静电纺丝技术制备 PLGA/PEG 可吸收电纺聚合膜,并行大体及扫描电镜观察。取 SD 大鼠 54 只,体质量 180~200 g,随机分为 3 组,其中正常对照组 6 只,不进行任何处理;模型组及 PLGA/PEG 组各 24 只,采用盲肠浆膜机械损伤方法制备腹腔粘连模型,术中 PLGA/PEG 组盲肠创面局部覆盖 PLGA/PEG可吸收电纺聚合膜,模型组不进行任何处理。术后 3 d 及 1、2、8 周,大体观察腹腔粘连情况并参照自定标准对腹腔粘连程度进行评级,PLGA/PEG 组观察 PLGA/PEG 可吸收电纺聚合膜降解情况;各时间点取标本进行组织学观察;以上指标均与正常对照组进行比较。结果采用静电纺丝技术成功制备 PLGA/PEG 可吸收电纺聚合膜,呈白色、不透明状,质地柔软;扫描电镜观察示,PLGA/PEG 可吸收电纺聚合膜主要由纤维无序交错堆积而成,具备微孔结构。术后大鼠均存活至实验完成。大体观察示,PLGA/PEG 可吸收电纺聚合膜植入大鼠体内后,随时间延长逐渐降解;PLGA/PEG 组腹腔粘连程度较模型组显著降低,各时间点粘连分级比较差异均有统计学意义(P<0.05),但尚未达正常对照组水平(P<0.05)。组织学观察示,各时间点与模型组相比,PLGA/PEG 组盲肠纤维结缔组织增生明显减缓,粘连程度明显降低,仅见少量炎性细胞浸润;但尚未达正常对照组水平。结论PLGA/PEG 可吸收电纺聚合膜能有效预防大鼠术后腹腔粘连,并具有良好生物降解性。

ObjectiveAdopting poly-L-lactic/glycolic acid (PLGA) and polyethylene glycol (PEG) as the material to fabricate PLGA/PEG electrospun polymer membrane by electrospinning technology. And to study its preventive effect on postoperative intraperitoneal adhesion of rat.MethodsPLGA and PEG were mixed at the ratio of 19∶1(M/M), then dissolved in organic solvent. The PLGA/PEG electrospun polymer membrane was prepared by electrospinning technology, and then the gross observation and scanning electron microscope observation were taken. Fifty-four Sprague Dawley rats (weighing, 180-200 g), were randomly divided into 3 groups. The rats in control group (n=6) were left intact. The rats in model group (n=24) and PLGA/PEG group (n=24) were treated with the method of mechanical injury of the cecal serosa in order to establish the intraperitoneal adhesion models; then the PLGA/PEG electrospun polymer membrane was used to cover the wound in PLGA/PEG group, but was not in the model group. The intraperitoneal adhesion in PLGA/PEG group and model group were observed at 3 days, 1 week, 2 weeks, and 8 weeks after operation, and the adhesion degree was assessed according to the self-generated standard. The degradation of PLGA/PEG electrospun polymer membrane was also observed in PLGA/PEG group. At each time point, the rats were harvested for histological observation. All the above indexes were compared with the control group.ResultsUsing the electrospinning technology, PLGA/PEG electrospun polymer membrane was prepared successfully. PLGA/PEG electrospun polymer membrane was white and opaque, with soft texture. Scanning electron microscopy observation showed that PLGA/PEG electrospun polymer membrane was mainly composed of disorderly staggered fibers, with microporous structure. All rats survived to the end of the experiment. Gross observation showed that PLGA/PEG electrospun polymer membrane gradually degraded after implantation in vivo, and the adhesion degree in PLGA/PEG group was significantly lower than that in model group (P<0.05), but it had not yet reached to the level of the control group (P<0.05). Histological observation showed that the proliferation of cecal fibrous connective tissue was slower in PLGA/PEG group than in model group, and adhesion severity significantly decreased, only with a small amount of inflammatory cell infiltration. Nevertheless, it was not up to the level of the control group.ConclusionPLGA/PEG electrospun polymer membrane can effectively prevent postoperative intraperitoneal adhesion of rat, and has good biodegradability.

关键词: 腹腔粘连; 静电纺丝技术; 防粘连膜; 聚乳酸/乙醇酸共聚物; 聚乙二醇; 生物降解性; 大鼠

Key words: Intraperitoneal adhesion; electrospinning technology; anti-adhesion membrane; poly-L-lactic/glycolic acid; polyethylene glycol; biodegradability; rat

引用本文: 陈灶妹, 赵月, 何婷, 陈柯君, 江丽, 张俊辉, 万华印, 李茹冰. PLGA/PEG 可吸收电纺聚合膜对大鼠腹腔术后粘连的预防作用研究. 中国修复重建外科杂志, 2017, 31(8): 999-1005. doi: 10.7507/1002-1892.201703083 复制

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