几种手术防粘连剂对凝血系统影响的体外试验

近年来手术防粘连剂在临床上得到广泛应用。在临床应用过程中发现壳聚糖类手术防粘连剂(羧甲基壳多糖)出现类似结膜炎的不良反应。本研究通过检测几丁糖、羧甲基壳多糖以及透明质酸钠凝胶在体外与血液接触后APTT、PT、Fib、PTT等凝血指标的变化,来初步估评它们对凝血系统的影响。实验结果显示,几丁糖和羧甲基壳多糖均引起了血浆PT、APTT、PTT的延长及Fib含量减少。与几丁糖相比,出现不良反应的羧甲基壳多糖对APTT的影响更大。而透明质酸钠与壳聚糖类手术防粘连剂相比,对凝血系统的影响较小。羧甲基壳多糖对凝血系统的影响是否造成临床应用时出现类似结膜炎的不良反应尚待进行更深入的研究。

Surgical adhesion prevention agent is widely used in surgery in recent years.The side-effects of chitin surgical adhesion prevention agent, such as conjunctivitis-like response, were found in the clinical application.To know whether this side-effect is related to the affects of chitin on the coagulation system,the affects of chitosan, carboxymethyl chitosan and sodium hyaluronate on the coagulation system were evaluated by determining PT, APTT, Fib PTT after contacting with blood in vitro.The results showed that both the chitosan and carboxymethyl chitosan induced the changes on the PT, APTT, Fib, PTT, and in contrasts,sodium hyaluronate showed more better blood compatibility than others.Whether these changes of coagulation system are the direct reason which caused the side-effects in the clinical application need further investigation.