丝裂霉素C联合光致亚胺交联水凝胶在犬声带损伤模型中的防粘连作用

doi:10.6040/j.issn.1673-3770.0.2019.199

摘要/Abstract

摘要： 目的探讨比格犬声带前联合粘连模型建立的可行性及光致亚胺交联水凝胶(HA-NB)与丝裂霉素C(MMC)联合应用的防粘连作用。方法 16条比格犬随机分为4个组:空白对照组、MMC组、HA-NB组、丝裂霉素C-水凝胶联用组(HN-MMC),每组4只。支撑喉镜下行声带前中段及前联合切除手术,术后观察大体形态并评估粘连程度,术后8周取组织活检进行切片染色,比较镜下形态变化。结果术后8周犬声带前联合粘连模型建立,可进行精确的粘连程度测量。HA-NB组与MMC组的粘连比例与对照组比较无统计学意义;HN-MMC 组的粘连比例小于对照组;析因设计的方差分析显示HA-NB与MMC的联合应用有协同作用; 镜下染色切片显示HN-MMC组瘢痕增生指数低于其余各组,瘢痕形成率低。结论丝裂霉素C联合光致亚胺交联水凝胶在犬声带前联合手术中达到了良好的防粘连效果,为预防声带术后粘连提供了较理想的材料。

关键词: 丝裂霉素C, 水凝凝胶, 声带粘连

Abstract: Objective To evaluate the feasibility of a canine model of vocal cord adhesion(VCA)and to determine the effectiveness of nitro-benzyl alcohol-modified hyaluronic acid(HA-NB)with mitomycin C(MMC)for the prevention of postoperative VCA using a canine model. Methods Sixteen male beagle dogs were divided into four groups(4 dogs in each group)and treated with saline(control group), HA-NB, MMC, or HN-MMC after VCA was induced by radiofrequency coblation using a suspension laryngoscope. At 8 weeks after surgery, the extent of VCA was determined to evaluate the preventive effects of HA-NB, MMC, and HN-MMC. All larynges were harvested and examined histologically. Results VCA induction was successful in all groups. VCA ratio was evaluated at 8 weeks after the initial surgery. The mean VCA ratio in both the HA-NB and MMC groups was not significantly different to that of the control group, but it was lower in the HN-MMC group than that in the control group. The estimated marginal means of HA-NB*MMC were lowest in the HN-MMC group and showed a significant synergistic interaction between HA-NB and MMC. The scar elevation index(SEI)in the HN-MMC group was significantly lower than that in any other groups. Conclusion The combination of HA-NB gel and MMC was more effective for the prevention of postoperative VCA formation than a single application of HA-based gel or MMC.

Key words: Mitomcin C, Hyaluronic acid, Vocal folds adhesion

中图分类号:

R767

宋志远, 易红良, 汪泱, 杨云龙. 丝裂霉素C联合光致亚胺交联水凝胶在犬声带损伤模型中的防粘连作用[J]. 山东大学耳鼻喉眼学报, 2019, 33(6): 78-80.

SONG Zhiyuan, YI Hongliang, WANG Yang, YANG Yunlong. Phototriggered imine-cross-linked hydrogels with mitomycin C for prevention of vocal cord adhesion after cordectomy: a canine model[J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2019, 33(6): 78-80.

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