透明质酸钠预防微波消融术后局部粘连的实验研究

目的:通过实验探讨透明质酸钠预防微波消融术后局部组织粘连的效果。方法:120只健康SD大鼠随机分为三组,每组40只,分别为微波消融组(A组,对照组)、微波消融加透明质酸钠组(B组)、微波消融加生理盐水组(C组)。通过对大鼠背部肌肉进行微波消融建立术后局部粘连模型,并在该模型基础上应用透明质酸钠,术后3 d、1 w、2 w、4 w分别对背部组织进行粘连分级、HE染色及免疫组化观察和分析。结果:消融术后3 d、1 w、2 w,B组在粘连分级方面A、B及C 3组间水平差异具有统计学意义P0.05);4 w时A、B、C组间的差异无统计学意义(P=0.458)。两两比较,A、C两组在四个时间点水平差异无统计学差异(P均0.05),而B组在消融术后3 d、1 w和2 w时,粘连分级明显优于A、C组,P=0.029(3 d)、P=0.011(1W)、P=0.004(2W),水平差异显著,有统计学意义;4 w时,P=0.391,无统计学意义。消融术后A、C组HE染色及免疫组化染色光镜下观察,淋巴细胞、巨噬细胞等炎症浸润情况及成纤维细胞数目均较B组多,且A、C组胶原纤维沉积明显多于B组。结论:透明质酸钠能够有效减轻微波消融术后发生的局部组织粘连。

Experimental Study of Sodium Hyaluronate in Preventing Adhesion after Microwave Ablation

ABSTRACT Objective: To determine the effectiveness of sodium hyaluronate in preventing local tissue adhesion after microwave ablation. Methods: 120 rats were randomly divided into three groups(40 rats in each group): microwave ablation group (group A), microwave ablation and sodium hyaluronate group (group B), microwave ablation and sodium hyaluronate saline group (group C). The local adhe- sion model was established in muscle of rat back by microwave ablation, and sodium hyaluronate was applied in this model during opera- tion. Biopsy was taken on the 3th, 7th, 14th and 28th postoperative day. The adhesion scores gradation judging, hematoxylin and Im- munohistochemistry were observed and analyzed. Results: There were statistically significantly differences in the extent of adhesion be- tween group B and group A, C on the 3th, 7th and 14th postoperative(P<0.05), after ablation 4W, there was not statistically signifi- cantly differences among A, B, C three groups (P=0.458). Comparison between the two group, there was no statistical significance be- tween the group A and C in the four time points (P>0.05), however, on the 3th, 7th and 14th postoperative day, group B were significantly less than group A , C in the extent of adhesion, and there was statistical significance, P=0.029(3d), P=0.011(1w), P=0.004(2w). After ablation 4w, P=0.391, there was no statistical significance between group B and group A, C.Group A and C were more than group B in the aspect of hematoxylin and immunohistochemical staining, the number of inflammatory cells infiltrated by lymphocytes, fibroblasts and macrophages, and the amount of collagen fiber deposition in A and C group were significantly harder than group B. Conclusion: Sodium hyaluronate appears to effectively reduce the local tissue adhesion after microwave ablation.