Düşük molekül ağırlıklı heparin, proksikam ve sisaprid' in intraabdominal adezyon üzerindeki etkileri
Küçük Resim Yok
Tarih
1998
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Ameliyat sonrası karın içi yapışıklıkların oluşması sık görülen bir durumdur. Barsak peristaltizminin azalması, enflamasyon ve doku iskemisi sorumlu tutulan faktörlerdendir. Çalışmamızda kontrol grubundaki ratlara (Grup 1) batın eksplorasyonu yapıldıktan sonra herhangi bir ilaç verilmemiş, diğer gruplarda ise karın içerisi düşük molekül ağırlıklı heparin (DMAH, Grup 2), non-steroid antienflamatuvar proksikam (Grup 3) ve prokinetik ajan sisaprid (Grup 4) verilmiştir. Ondördüncü günde raflar sakrifiye edilerek karın içifibröz bant sayısı ve enflamasyonun şiddeti karşılaştırılmıştır. Kontrol grubunda 3/10 ratta fibröz band sayısı 3'ün altında bulundu. Proksikam ve sisaprid fibröz band oluşumunu önemli derecede etkilememişlerdir. DMAH verilen grupta ise 9/10 ratta fibröz band oluşumu 3'ün altında görüldü. Kontrol grubuna oranla bu fark istatistiksel olarak anlamlıydı (p<0.05). Ayrıca bu grupta enflamasyon şiddetinin derecesi kontrol grubuna oranla daha düşüktü (p<0.05). Düşük molekül ağırlıklı heparin'in adezyonu azaltması, bu ajanın mikfotrombüs oluşumunu engelleyerek kan akımının devamlılığını sağlamasına böylece yaralanma sahasında iskemiyi engellemesine bağlanmıştır.
Post-operative intraabdominal adhesions are not uncommon. Decrease in intestinal motility, inflammation and-tissue ischemia are the responsible factors. In this study, following the intraabdominal exploration, no treatment was given to the control (Group 1) group, low molecular weight heparin (LMWH, Group 2), non-steroidal anti-inflammatory agent proxicam (Group 3), and prokinetic agent cisaprid (Group 4) were administered intraperitoneally to other groups. All rats were sacrified after 14 days, and the number of fibrotic bands were compared with the control group, as well as the intensity of the inflammation. Number of fibrotic bands were less than 3 in 3/10 rats in the control group. Proxicam and cisaprid did not significantly affect fibrotic band formation. On the other hand, less than 3 fibrotic bands were seen in 9/10 of the group receiving LMWH, which was significantly different compared to the control group (p<0.05). In addition, the intensity of inflammation was significantly lower than the control group (p<0.05). The ability of LMWH to reduce adhesion formation was attributed to inhibition of microthrombus formation, maintaining microvascular circulation thus avoiding ischemia in the injured area.
Post-operative intraabdominal adhesions are not uncommon. Decrease in intestinal motility, inflammation and-tissue ischemia are the responsible factors. In this study, following the intraabdominal exploration, no treatment was given to the control (Group 1) group, low molecular weight heparin (LMWH, Group 2), non-steroidal anti-inflammatory agent proxicam (Group 3), and prokinetic agent cisaprid (Group 4) were administered intraperitoneally to other groups. All rats were sacrified after 14 days, and the number of fibrotic bands were compared with the control group, as well as the intensity of the inflammation. Number of fibrotic bands were less than 3 in 3/10 rats in the control group. Proxicam and cisaprid did not significantly affect fibrotic band formation. On the other hand, less than 3 fibrotic bands were seen in 9/10 of the group receiving LMWH, which was significantly different compared to the control group (p<0.05). In addition, the intensity of inflammation was significantly lower than the control group (p<0.05). The ability of LMWH to reduce adhesion formation was attributed to inhibition of microthrombus formation, maintaining microvascular circulation thus avoiding ischemia in the injured area.
Açıklama
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Kaynak
Çağdaş Cerrahi Dergisi
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Scopus Q Değeri
Cilt
12
Sayı
1
