中国组织工程研究

中国组织工程研究 ›› 2011, Vol. 15 ›› Issue (12): 2217-2220.doi: 10.3969/j.issn.1673-8225.2011.12.031

• 生物材料学术探讨 biomaterial academic discussion • 上一篇    下一篇

透明质酸钠凝胶预防剖宫产后宫腔粘连的临床应用

赵永红，徐  颖   

  1. 解放军第二五一医院妇产科，河北省张家口市　   075000
  • 收稿日期:2010-12-14 修回日期:2011-02-22 出版日期:2011-03-19 发布日期:2011-03-19
  • 通讯作者: 徐颖，硕士，主治医师，解放军第二五一医院妇产科，河北省张家口市075000
  • 作者简介:赵永红，女，1966年生，河北省张家口市人，汉族，副主任护师，主要从事妇产科临床护理研究。 zhaoyonghong2010@163.com

Clinical application of sodium hyaluronate gel for prevention of intrauterine adhesious after uterine-incision delivery

Zhao Yong-hong, Xu Ying   

  1. Department of Gynecology and Obstetrics, The 251 Hospital of Chinese PLA, Zhangjiakou  075000, Hebei Province, China
  • Received:2010-12-14 Revised:2011-02-22 Online:2011-03-19 Published:2011-03-19
  • Contact: Xu Ying, Master, Attending physician, Department of Gynecology and Obstetrics, The 251 Hospital of Chinese PLA, Zhangjiakou 075000, Hebei Province, China
  • About author:Zhao Yong-hong, Associate chief superintendent nurse, Department of Gynecology and Obstetrics, The 251 Hospital of Chinese PLA, Zhangjiakou 075000, Hebei Province, China zhaoyonghong2010@163.com

PDF

792

被引次数

80

摘要：

背景：透明质酸钠具有预防盆、腹腔粘连的作用，但透明质酸钠宫腔停留时间短，难以达到预防宫腔粘连的作用。国外研究对透明质酸钠进行化学修饰形成自交联透明质酸钠凝胶，它对受损的宫内膜具有很强的黏附性，在宫腔内停留时间可达72 h。
目的：评价透明质酸钠凝胶在剖宫产后预防宫腔粘连的效果及安全性。
方法：由第一作者检索PubMed数据库(http://www.ncbi.nlm.nih.gov/PubMed)及维普数据库(http://www.cqvip.com/)有关透明质酸钠凝胶预防剖宫产后宫腔粘连的文献，检索时限为1990-01/2009-12，中文关键词为“透明质酸钠凝胶，剖宫产，粘连，宫腔粘连”，英文关键词为“sodium hyaluronate，cesarean section，adhesion，intrauterine adhesions”，排除重复研究或综述类文章。
结果与结论：共检索到相关文献150余篇，排除内容重复、综述类文章后筛选纳入16篇文献进行评价，其中中文12篇，英文4篇。结果显示，透明质酸钠凝胶是由N-乙酰葡萄糖醛酸反复交替而形成的一种高分子多糖体生物材料，具有高度的黏弹性、可塑性以及良好的生物相容性，在剖宫产后预防宫腔粘连效果明显，特别是能有效减少分离后再粘连的发生。但有一点十分重要，透明质酸钠凝胶是绝对不能用于血管内的，以免引起肺栓塞并发症。注射过程应缓慢，以免回流入静脉系统。

关键词: 透明质酸钠凝胶, 透明质酸钠, 剖宫产, 宫腔粘连, 预防

Abstract:

BACKGROUND: Sodium hyaluronate has precaution basin and celiac adhesion effects, but because of short residence time of uterine cavity of sodium hyaluronate, it is difficult to prevent intrauterine adhesious. The researches at abroad reported that sodium hyaluronate was chemically modified and then formed self-cross-linked sodium hyaluronate gel. It has a strong adhesion in impaired endometrium, and the residence time in the uterine cavity up to 72 hours.
OBJECTIVE: To evaluate the effect and safety of sodium hyaluronate gel on the prevention of intrauterine adhesious after uterine-incision delivery.
METHODS: Literatures related to sodium hyaluronate gel for prevention of intrauterine adhesious after uterine-incision delivery from PubMed database (http://www.ncbi.nlm.nih.gov/PubMed), VIP database (http://www.cqvip.com/) were retrieved, with the key words of “sodium hyaluronate, cesarean section, adhesion, intrauterine adhesions” in Chinese and English respectively. The retrieval time was limited to 1990-01/2009-12. Duplicated and reviewed researches were excluded.
RESULTS AND CONCLUSION: Totally more than 150 articles were obtained. After duplicated and reviewed researches were excluded, 16 of them were involved for evaluation (12 Chinese, 4 English). The results showed that sodium hyaluronate gel is high molecular polysaccharide biomaterial formed by iterative N-acetyl-glucuronide, which has a high degree of elasticity, plasticity, and good biocompatibility. Sodium hyaluronate gel has a significant effect in prevention of intrauterine adhesious after uterine-incision delivery, especially can effectively reduce the incidence of re-adhesion after separation. But one thing is important that sodium hyaluronate gel is absolutely cannot be used in vascular, in order to avoid complications caused by pulmonary embolism. Injection process should be slow, lest back into venous system.

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