论文部分内容阅读
目的探讨透明质酸钠对兔脓胸胸膜粘连及纤维化的影响。方法 20只雄性新西兰大白兔随机分为治疗组和对照组,每组10只。在右侧胸膜腔放置导管后,相继注入松节油和金黄色葡萄球菌以诱导脓胸形成,24 h 时抽取全部胸腔积液,脓胸被证实后,治疗组胸膜腔内注入透明质酸钠3 ml(30 mg),对照组注入生理盐水3 ml。所有动物于24 h 后肌内注射青霉素20万 U/d。96 h 时再次抽取胸腔积液,检测2次胸腔积液中的白细胞数、中性粒细胞比值、蛋白含量、葡萄糖浓度及 pH值。第8天处死兔并开胸观察。结果每组各有9只兔完成实验,治疗组和对照组96 h 时胸腔积液中白细胞数分别为(25±13)×10~9/L 和(37±10)×10~9/L,中性粒细胞比值分别为0.27±0.11和0.50±0.11,蛋白含量分别为(30±4)g/L 和(36±4)g/L,治疗组均显著低于对照组,96 h 胸腔积液中治疗组葡萄糖浓度为(2.4±0.5)mmol/L,显著高于对照组的(3.8±1.3)mmol/L。治疗组和对照组胸膜粘连积分分别为(0.7±0.5)和(3.2±0.7)分,脏层胸膜厚度分别为(28±10)μm和(156±42)μm,成纤维细胞数分别为(37±15)个/mm~2和(163±58)个/mm~2,治疗组均明显少于对照组。结论早期胸膜腔内注入高分子量透明质酸钠可显著减轻兔脓胸胸膜粘连及纤维化,且安全性好。
Objective To investigate the effect of sodium hyaluronate on pleural adhesions and fibrosis in rabbit empyema. Methods Twenty male New Zealand white rabbits were randomly divided into treatment group and control group, with 10 in each group. After placement of the catheter in the right pleural cavity, injecting turpentine and Staphylococcus aureus successively to induce the formation of empyema. After 24 hours, all the pleural effusion was withdrawn. After the empyema was confirmed, the treatment group received intrapleural injection of 3 ml of sodium hyaluronate (30 mg), control group injected with normal saline 3 ml. All animals received intramuscular penicillin 200,000 U / d after 24 h. Pleural effusion was drawn again at 96 h, and the number of leukocytes, neutrophil, protein, glucose and pH in 2 pleural effusions were measured. On the 8th day, rabbits were sacrificed and thoracotomy observed. Results Nine rabbits in each group completed the experiment. The numbers of leukocytes in the pleural effusion of the treatment group and the control group were (25 ± 13) × 10 ~ 9 / L and (37 ± 10) × 10 ~ 9 / L , The neutrophil ratios were 0.27 ± 0.11 and 0.50 ± 0.11, respectively, and the protein contents were (30 ± 4) g / L and (36 ± 4) g / L, respectively. The treatment group was significantly lower than the control group The concentration of glucose in the effusion group was (2.4 ± 0.5) mmol / L, which was significantly higher than that in the control group (3.8 ± 1.3) mmol / L. The pleural adhesion scores in the treatment group and the control group were (0.7 ± 0.5) and (3.2 ± 0.7) points respectively, and the visceral pleural thicknesses were (28 ± 10) μm and (156 ± 42) μm respectively. The number of fibroblasts were ( 37 ± 15) / mm ~ 2 and (163 ± 58) / mm ~ 2, the treatment group were significantly less than the control group. Conclusion Early intrapleural injection of high molecular weight sodium hyaluronate can significantly reduce pleural adhesions and fibrosis of the rabbit empyema, and is safe.