Development of a novel glucose polymer solution (icodextrin) for adhesion prevention: pre-clinical studies
Development of a novel glucose polymer solution (icodextrin) for adhesion prevention: pre-clinical studies
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DOI：
10.1093/humrep/15.8.1764
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发表时间：
2000-08-01
影响因子：
6.1
通讯作者：
diZerega, G
中科院分区：
文献类型：
--
作者：
Verco, SJS;Peers, EM;diZerega, G
腹腔内粘连形成导致显著的术后发病率，已使用动物模型进行了对照研究，以评估艾考糊精溶液（一种可生物降解、生物相容的葡萄糖聚合物）的耐受性和预防有效性。首先在兔双子宫角模型中评价粘连形成的减少，术后应用10-75 ml 7.5和20%或50 ml 2.5-20%艾考糊精溶液。在体积大于或等于25 ml和浓度大于或等于4%时，观察到无粘连部位显著增加（P < 0.005）。然后在术中和术后评价50 ml 4和20%艾考糊精的有效性，证明粘连形成显著减少（P < 0.002）。在一项研究中，术中加术后使用4%艾考糊精可最大程度地减少非手术部位粘连;在其他研究中，术后效果占主导地位。在兔侧壁模型中，术后给予50 ml 4%艾考糊精也导致更多的无粘连动物，粘连形成和再形成面积显著减少（P < 0.001）。在大鼠感染增强模型中，4%艾考糊精在死亡率、脓肿形成或总体脓肿评分方面无差异。这些数据表明，4%艾考糊精提供了一种耐受性良好且有效的减少术后粘连形成的方法。
Intra-abdominal adhesion formation causes significant post-operative morbidity, Controlled studies using animal models have been carried out to assess the tolerability and preventive efficacy of icodextrin solution (a biodegradable, biocompatible, glucose polymer). Reduction of adhesion formation was first evaluated in a rabbit double uterine horn model, applying 10-75 ml of 7.5 and 20%, or 50 ml of 2.5-20% icodextrin solution post-operatively. Significant increases in adhesion free sites (P < 0.005) were observed with volumes greater than or equal to 25 mi, and at concentrations greater than or equal to 4%. Efficacy of 50 mi 4 and 20% icodextrin was then evaluated both during and after surgery, demonstrating significant reductions in adhesion formation (P < 0.002), In one study, intraplus post-operative use of 4% icodextrin produced the greatest reduction of non-surgical site adhesions; in others, the post-operative effect was predominant. Post-surgical administration of 50 mi 4% icodextrin in a rabbit sidewall model also resulted in more adhesion-free animals, and a significant reduction (P < 0.001) in areas of adhesion formation and reformation. In a rat infection potentiation model, 4% icodextrin produced no difference in mortality, abscess formation or overall abscess score. These data suggest that 4% icodextrin offers a well-tolerated and effective means of reducing post-surgical adhesion formation.