CAJ | 학술논문

目的：探讨医用透明质酸钠凝胶预防妇科肿瘤术后粘连的临床效果。方法选取2013年5月~2014年4月在本院进行手术治疗的120例妇科肿瘤患者为研究对象，将患者随机分为对照组(常规手术治疗)和观察组(常规手术治疗基础上加用医用透明质酸钠凝胶)，每组60例。比较两组患者的术后粘连发生率及治疗前后的腹腔粘连相关指标。结果对照组中采用腹腔镜手术者的粘连发生率为10.00%，采用开腹手术者为15.00%，明显高于观察组腹腔镜手术者的0及开腹手术者的2.50%(P<0.05)；治疗后3 d，对照组的透明质酸(HA)、层粘蛋白(LN)、肾组织转化生长因子β1(TGF-β1)及纤维连接蛋白(Fn)分别为(35.83±3.54)μg/L、(33.34±2.69) ng/ml、(72.17±8.95)μg/L、(13.57±1.68)ng/ml，明显高于观察组的(28.52±3.10)μg/L、(22.37±2.38)ng/ml、(58.36±7.18)μg/L、(8.92±1.2)ng/ml(P<0.05)；治疗后7 d，对照组的HA、LN、TGF-β1及Fn为(30.15±3.26)μg/L、(25.60±2.41)ng/ml、(60.33±7.26)μg/L、(10.25±1.33)ng/ml，明显高于观察组的(23.21±2.87)μg/L、(17.42±2.24)ng/ml、(45.29±6.37)μg/L、(7.05±0.73)ng/ml(P<0.05)。结论医用透明质酸钠凝胶预防妇科肿瘤术后粘连的临床效果较好，对患者术后的康复有积极作用。
목적：탐토의용투명질산납응효예방부과종류술후점련적림상효과。방법선취2013년5월~2014년4월재본원진행수술치료적120례부과종류환자위연구대상，장환자수궤분위대조조(상규수술치료)화관찰조(상규수술치료기출상가용의용투명질산납응효)，매조60례。비교량조환자적술후점련발생솔급치료전후적복강점련상관지표。결과대조조중채용복강경수술자적점련발생솔위10.00%，채용개복수술자위15.00%，명현고우관찰조복강경수술자적0급개복수술자적2.50%(P<0.05)；치료후3 d，대조조적투명질산(HA)、층점단백(LN)、신조직전화생장인자β1(TGF-β1)급섬유련접단백(Fn)분별위(35.83±3.54)μg/L、(33.34±2.69) ng/ml、(72.17±8.95)μg/L、(13.57±1.68)ng/ml，명현고우관찰조적(28.52±3.10)μg/L、(22.37±2.38)ng/ml、(58.36±7.18)μg/L、(8.92±1.2)ng/ml(P<0.05)；치료후7 d，대조조적HA、LN、TGF-β1급Fn위(30.15±3.26)μg/L、(25.60±2.41)ng/ml、(60.33±7.26)μg/L、(10.25±1.33)ng/ml，명현고우관찰조적(23.21±2.87)μg/L、(17.42±2.24)ng/ml、(45.29±6.37)μg/L、(7.05±0.73)ng/ml(P<0.05)。결론의용투명질산납응효예방부과종류술후점련적림상효과교호，대환자술후적강복유적겁작용。
Objective To study the clinical effect of medical sodium hyaluronate gel in the prevention of postoperative adhesions in gynecological tumor. Methods 120 patients with gynecological tumor undergone surgery in our hospital from May 2013 to April 2014 were selected as research objects,and they were randomly and evenly divided into control group (routine operation treatment) and observation group (on the basis of routine operation treatment adding medical sodium hyaluronate gel),the incidence rate of postoperative adhesions and related indexes of peritoneal fluid adhesion before and after treatment between two groups were compared. Results The incidence rate of adhesion in patients un-dergone laparoscopic surgery in control group (10.00%) and incidence rate of adhesion in patients undergone laparoto-my (15.00%) much higher than those in observation group (0 and 2.50% respectively) with statistical difference (P<0.05).After 3 days treatment,indexes of hyaluronic acid (HA),laminin (LN),tumor growth factor-β1 (TGF-β1) and fi-bronectin (Fn) in control group [(35.83±3.54) μg/L,(33.34±2.69) ng/ml,(72.17±8.95) μg/L and (13.57±1.68) ng/ml re-spectively] was remarkably higher than that in control group [(28.52±3.10) μg/L,(22.37±2.38) ng/ml,(58.36±7.18) μg/L and (8.92±1.2) ng/ml respectively] respectively,the difference was significant (P<0.05).After 7 days treatment,indexes of HA,LN,TGF-β1 and Fn [(30.15±3.26) μg/L,(25.60±2.41) ng/ml,(60.33±7.26) μg/L and (10.25±1.33) ng/ml reapectively] in control group was obviously higher than that in observation group[(23.21±2.87)μg/L,(17.42±2.24) ng/ml,(45.29±6.37)μg/L and (7.05±0.73) ng/ml respectively] respectively,and the difference was significant (P<0.05). Conclusion Medical sodi-um hyaluronate gel obtains a good clinical effect in preventing postoperative adhesions in gynecological tumor and plays a positive role in patient’s rehabilitation after surgery.