CN104958790B - Prevent the composite membrane of postoperative intestinal adhesion - Google Patents
Prevent the composite membrane of postoperative intestinal adhesion Download PDFInfo
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- CN104958790B CN104958790B CN201510447812.5A CN201510447812A CN104958790B CN 104958790 B CN104958790 B CN 104958790B CN 201510447812 A CN201510447812 A CN 201510447812A CN 104958790 B CN104958790 B CN 104958790B
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- adhesion
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- hyaluronic acid
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Abstract
The present invention relates to a kind of composite membrane for preventing postoperative intestinal adhesion, belong to technical field of membrane, the composite membrane includes polysaccharide, hyaluronic acid, HES, glycerine, sodium chloride, and the polysaccharide, hyaluronic acid, HES, the weight ratio of glycerine and sodium chloride are 15~40：3~5：1~40：45~75：25~30, the polysaccharide is chitin, chitosan or chitin polysaccharide, and the composite membrane energy long-acting stabilization of the invention for having the beneficial effect that preparation is covered in wound surface, and being reached by physical barrier prevents and other organ or tissue's adhesion purposes.
Description
Technical field
The present invention relates to a kind of composite membrane for preventing postoperative intestinal adhesion, belong to technical field of membrane.
Background technology
Tissue adhesion (adhesion) is the wound as caused by inflammation, friction, operation etc., is produced over the course for the treatment of excessive
Fibr tissue or bleeding form clot, periphery internal organs is produced the phenomenon of adhesion with tissue.This phenomenon is in human abdominal cavity, the heart
The surgical site infections such as blood vessel, backbone, Bones and joints, gynecologic are very easy to occur.The wherein position adhesion in abdominal cavity and pelvic cavity
Incidence is up to more than 90%, and 20% or so female acyesis patient is caused by pelvic adhesion, and 30% adhesion has obvious disease
Shape, such as chronic pelvic pain, nausea, gaseous distention and constipation etc. caused by intestinal adhesion.Tissue adhesion not only brings greatly to patient
Pain, its normal work and life are had a strong impact on, and long-term medical expense brings huge economy to patient and its family
Burden.In order to solve the problems, such as post-operation adhesion, relevant technical worker both domestic and external is carried out unremitting effort, arranged using various always
Apply to be prevented and treated, such as modus operandi；Remove Fibrin exudation thing；Separate intestinal tube surface, injection air etc..Though these methods
Prevention of postoperative adhesion can so be played a part of, but effect is not affirmed, in order to reach prevention of postoperative adhesion purpose, it is necessary to make for a long time
With strong dose thing, this makes generation side effect or the sick danger issued licence prevent intestinal adhesion often beyond them and can obtain
Beneficial effect.
With going deep into for research, adherence preventing material comes out successively, and is progressively applied to clinic, wherein representational be exactly
Hyaluronic acid.Hyaluronic acid (Haluronic acid, HA) also known as Hyaluronic Acid, hyaluronic acid is a kind of acid mucopolysaccharide, by N-
The linear polysaccharide structure of the repetitive structure of acylamino- glucose and D-Glucose aldehydic acid composition, its unique molecular structure and reason
Change property and show a variety of important physiological functions in body, such as lubricating joint, adjust the permeability of vascular wall, regulatory protein
Matter, Water-Electrolyte diffusion and operating, promote wound healing etc..The soft junction for being present in most of animal body due to hyaluronic acid forms group
In knitting, therefore there is biocompatibility and nontoxic characteristic, be widely used in countries such as Japan, the U.S..Pharmaceutically will
Hyaluronic acid is applied to eye drops, surgical material and injection.Published in No. 4,141,973 United States Patent (USP) due to saturating
Bright matter acid can not only suppress bleeding, and can suppress granulocyte migration and phagocytosis, have good antiinflammatory action, so as to have
There is preventing tissue adhesion effect.But because it is easily decomposed by body absorption in vivo, limit preventing tissue adhesion effect.In order to
Improve hyaluronic acid easily to decompose in vivo, United States Patent (USP) (Patent No. 6,387,413B1) is taken high to hyaluronic acid grafting
The method of molecular compound (Carboxymethyl cellulose, CMC) has delayed its decomposition rate in vivo, party's legal system
Although cellulose in standby Antiadhesive film is natural macromolecular material, but because it is not biological substance in vivo, be injected in vivo
When, react with some internal materials, so as to trigger adverse reaction, plus the enzyme not decomposed in vivo to it, therefore it is entered
After water-filling solution, oxidation processes, it could use in vivo.United States Patent (USP) (Patent No. 5,017,229) has been published using saturating
Bright matter acid is transferred by EDC [1-ethyl-3 (3-dimethylaminopropyl) carbodilimide hydrochloride]
Connect CMC (Carboxymethyl cellulose) high polymer material and prepare the anti-sticking membrane technology of hydrophobicity, its grafting method is logical
Cross what positive and negative charge between compound was combined into, the Antiadhesive film is not easy to decompose, and has an effect of preventing adhesion, but EDCization
Learn material has toxicity to human body, removes it and takes long enough specially treated process.
In summary, although the adherence preventing material developed at present has anti-blocking properties, due to passing through chemical method system
Standby anti-blocking properties material is difficult to remove to promote synthesis chemical addition agent, therefore its toxic turns into safety issue restricts
The bottleneck of its wide clinical application.Used anti-blocking agent is mostly hydrogel at present in market, and quantity is big, and cost is high；Together
The extraneous factors such as Shi Yinwei environment can shine into effective ingredient can not uniformly, specifically act on wound site.
The content of the invention
The present invention is acted on by preparing the physical barrier of Novel composite membrane, and reaching prevents that tissue adhesion shows caused by Post operation
As, while Novel composite membrane also has anti-inflammation, promotes the multi-biological effects such as wound healing.
The invention provides a kind of composite membrane for preventing postoperative intestinal adhesion, the composite membrane includes polysaccharide, hyaluronic acid, hydroxyl
Hydroxyethyl starch, glycerine, sodium chloride, the polysaccharide, hyaluronic acid, HES, the weight ratio of glycerine and sodium chloride for 15~
40：3~5：1~40：45~75：25~30, the polysaccharide is chitin, chitosan or chitin polysaccharide.
The molecular weight of chitin of the present invention is preferably 0.5 × 105~2 × 105Dalton.
The molecular weight of chitosan of the present invention is preferably 0.2 × 105~1 × 105Dalton.
The molecular weight of chitin polysaccharide of the present invention is preferably 0.8 × 105~1.2 × 105Dalton.
The molecular weight of hyaluronic acid of the present invention is preferably 0.8 × 106~3 × 106Dalton, the viscosity of hyaluronic acid
Preferably 30~35dl/g.
The molecular weight of HES of the present invention is preferably 7 × 104~6.7 × 105Dalton, HES
Water substitution degree is preferably 0.4~0.75.The present invention has the beneficial effect that：
1. the long-acting stabilization of composite membrane energy of preparation of the present invention is covered in wound surface, reach anti-by physical barrier
Only with other organ or tissue's adhesion purposes；
2. the composite membrane of preparation of the present invention has the function that anti-inflammation and promotes wound healing；
3. the composite membrane composition safety of preparation of the present invention, can be absorbed by organisms.
Brief description of the drawings
The width of accompanying drawing 6 of the present invention,
Fig. 1 is the animal abdominal cavity adhesion figure of 1 group of control group；
Fig. 2 is the adhesion site area measurement figure of 1 group of control group；
Fig. 3 is the animal abdominal cavity adhesion figure of 2 groups of control group；
Fig. 4 is the adhesion site area measurement figure of 2 groups of control group；
Fig. 5 is the animal abdominal cavity adhesion figure of 1 group of embodiment；
Fig. 6 is the adhesion site area measurement figure of 1 group of embodiment.
Embodiment
Following non-limiting examples can make one of ordinary skill in the art be more fully understood the present invention, but not with
Any mode limits the present invention.
Following chitins are purchased from Shaanxi Pa Nier bio tech ltd, and the molecular weight of chitin is 0.5 × 105~2
×105Dalton；
Following chitosans are purchased from Shaanxi Pa Nier bio tech ltd, and the molecular weight that the molecular weight of chitosan is is
0.2×105~1 × 105Dalton；
Following chitin polysaccharide are purchased from Shaanxi Pa Nier bio tech ltd, and the molecular weight of chitin polysaccharide is 0.8
×105~1.2 × 105Dalton；
Following hyaluronic acids are purchased from Shaanxi Pa Nier bio tech ltd, and the molecular weight of hyaluronic acid is 0.8 × 106
~3 × 106Dalton, the viscosity of hyaluronic acid is 30~35dl/g；
Following HESs are purchased from Shaanxi Pa Nier bio tech ltd, the molecular weight of HES for 7 ×
104~6.7 × 105Dalton, the water substitution degree of HES is 0.75~0.4；
Your Thailand of following arts is purchased from Beijing De Long Weirs Science and Technology Ltd..
Embodiment 1
A kind of preparation method for the chitin/hyaluronic acid composite membrane for preventing postoperative intestinal adhesion, the preparation method include
Following steps：
1. chitin and physiological saline are mixed to get 4wt% chitin normal saline solutions, by 4wt% chitin physiology
Saline solution mixes with 10% (V/V) acetic acid, 4 DEG C of standing 48h, obtains solution I；
The volume ratio of the 4wt% chitins normal saline solution and 10% (V/V) acetic acid is 1：0.85；
2. hyaluronic acid and physiological saline are mixed to get into 0.5wt% hyaluronic acid normal saline solutions, 4 DEG C stand 48h,
Obtain solution II；
3. HES and physiological saline are mixed to get 2wt% HESs normal saline solution III；
By solution I, solution II and solution III by volume 1：1：1 mixing, add glycerine and obtain 5wt% solution IV, stir
10min, ultrasonic 2min, 4 DEG C of standing 24h obtain film forming solution, and the film forming that 20mL film forming solutions are added to 10cm × 10cm is held
In device, uniformly sprawl, be dried to obtain that smooth, bright, transparency is high, is 0.03mm first without greasy feeling, the thickness that matter is soft, toughness is strong
Shell element/hyaluronic acid composite membrane.
Embodiment 2
A kind of preparation method for the chitosan/hyaluronic acid composite membrane for preventing postoperative intestinal adhesion, with being distinguished as embodiment 1
Chitin is replaced using chitosan.
Embodiment 3
The preparation method of chitin polysaccharide/hyaluronic acid composite membrane of postoperative intestinal adhesion is prevented, with being distinguished as embodiment 1
Chitin is replaced using chitin polysaccharide.
Application examples 1
Intestinal adhesion is tested：
Using intraperitoneal injection yellow Jackets (30mg/kg) anesthetized rat, when animal is quiet, breathing steadily balances, blood pressure
Normally, wall is of flaccid muscles, corneal reflection blunt performance when can carry out every test operation.Dorsal position is fixed after Animal Anesthesia,
Cropping is sterilized, and median abdominal incision is removed under sterile working, long 3~4cm, finds out caecum part after opening abdominal cavity, caecum portion uses dry
Gauze is gently wiped to intestines serous layer serous coat and is damaged repeatedly, and damaged area is 1.2cm × 1.2cm, and showing as surface has needle point big
Blood point, gauze dye light red color.Equally big area is damaged in damage location opposite abdominal wall medication spoon.Caecum pars affecta
Position, which is fixed on, to build abdominal cavity adhesion animal mould with the symmetrical abdominal wall position of abdominal wall damage location, promoting adhesion
Type.Control group 1 wipes physiological saline between caecum damage location and abdominal wall damage location；Control group 2 is in caecum pars affecta
The safe 2mL of art that is wiped between position and abdominal wall damage location；1 group of embodiment caecum damage location and abdominal wall damage location it
Between cover embodiment 1 prepare chitin/hyaluronic acid composite membrane.Then abdomen is successively closed, is sutured.Post operation animal fasting 12h,
Sub-cage rearing, feed are full nutrition rat grain feed.Open abdomen after one week to examine, draw materials, judge adhesion grade, experimental result is shown in Table
1。
Grade scale is commented to determine rat adhesion situation according to middle inspection：0 grade：Entirely without adhesion；I grade：It is locally slight at 1~2
Adhesion, it can be separated with finger；II grade：There is I grade of adhesion more than at two；III grade：There is extensive adhesion, be partially separated difficulty；IV grade：
Caecum and cavity wall close adhesion, separation are difficult.
The intestinal adhesion experimental result of table 1
| Degree of adhesion | Adhesion area (cm2) | Adhesion Ratio of decreased area (%) | |
| 1 group of control group | Ⅳ | 1.36±0.25 | 0 |
| 2 groups of control group | Ⅲ | 0.78±0.12** | 42.7 |
| 1 group of embodiment | Ⅰ | 0.29±0.17* | 78.7 |
1 group of embodiment and 1 group of ratio of control group, * p<0.05,2 groups of control group and 1 group of ratio of embodiment, * * p<0.05
Obtained by table 1, with 1 group of ratio of control group, tissue adhesion's degree of 1 group of embodiment substantially reduces.In addition, with 1 group of control group
Than 2 groups of adhesion areas of control group reduce 42.7%, and 1 group of adhesion area of embodiment reduces 78.7%.
Claims (1)
1. prevent the composite membrane of postoperative intestinal adhesion, it is characterised in that：The composite membrane includes polysaccharide, hyaluronic acid, ethoxy and formed sediment
Powder, glycerine, sodium chloride, the polysaccharide, hyaluronic acid, HES, the weight ratio of glycerine and sodium chloride are 15~40：3~
5：1~40：45~75：25~30, the polysaccharide is chitin, chitosan or chitin polysaccharide；
The molecular weight of the chitin is 0.5 × 105~2 × 105Dalton；
The molecular weight of the chitosan is 0.2 × 105~1 × 105Dalton；
The molecular weight of the chitin polysaccharide is 0.8 × 105~1.2 × 105Dalton；
The molecular weight of the hyaluronic acid is 0.8 × 106~3 × 106Dalton, the viscosity of hyaluronic acid is 30~35dl/g；
The molecular weight of the HES is 7 × 104~6.7 × 105Dalton, the water substitution degree of HES is 0.4
~0.75.
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| CN108066827A (en) * | 2018-02-07 | 2018-05-25 | 苏州元禾医疗器械有限公司 | A kind of biomembrane for preventing postoperative tissue adhesion |
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| CN1515323A (en) * | 2003-01-09 | 2004-07-28 | 成都博联医疗信息产业有限责任公司 | Preparation method of flexible absorbable medical film material |
| CN1537641A (en) * | 2003-04-18 | 2004-10-20 | 上海建华精细生物制品有限公司 | Sodium hyaluronate anti-adhesion film, and its prepn. method |
| CN1557508A (en) * | 2004-01-13 | 2004-12-29 | 都本立 | Adhesion preventing membrane and its preparing method |
| CN1569262A (en) * | 2004-05-12 | 2005-01-26 | 中国海洋大学 | Carboxymethyl chitin membrane for postoperative adhesion prevention and its preparation method |
| CN101485897A (en) * | 2008-01-14 | 2009-07-22 | 纪欣 | Biocompatible hemostatic, antiblocking, healing-promoting and surgical wound-closing modified starch material |
| CN101669964A (en) * | 2009-09-30 | 2010-03-17 | 大连大学 | Surgery anti-adhesion agent and preparation method thereof |
| CN102380121A (en) * | 2011-10-31 | 2012-03-21 | 昆明理工大学 | Medical anti-adhesion material with controllable degradation and preparation method thereof |
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| CN104958790A (en) | 2015-10-07 |
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