[Characteristics of genesis and development of peritoneal adhesion by different causes: experiment with rats].

Objective To investigate the characteristics of genesis and development of peritoneal adhesion by different causes. Methods 236 rats underwent laporotomy with their vermiform processes lifted up and were randomly divided into 5 groups: Group A (control group), with the vermiform process exposed to air for 5 min, Group B, with the vermiform process smeared with talcum powder; Group C, with the vermiform process scraped by scalpel; Group D, with the tip of vermiform process stabbed by needle so as to squeeze the contents of intestine to cause infection; and Group E, with the artery of vermiform process ligated. Then the abdominal incision was sutured. 1, 2, 4, and 6 weeks after the treatment 11~12 rata from each group were randomly to undergo laporotomy. The degree of adhesion was graded blindly by Bhatia′s method. The vermiform process was resected to undergo pathological examination and examination of the level of organ hydroxyproline (OHP) was detected. Results (1) At different time points the adhesive grades of Groups B~E were all significantly higher than that of Group A (all P0.05) and the adhesive grades of Groups B and D were both significantly higher than those of Groups C and E (both P0.05). There were no significant differences in the adhesive degree 1, 2, and 4 weeks after the treatment between Groups C and E, however, the adhesive degree of Group E was significantly lower than that of Group C (P0.05). (2) There were not significant differences in the OHP levels at any time points in Group A (all P0.05). There were not significant differences in the OHP levels 1, 2, and 4 weeks after the treatment (all P0.05), and the levels 8 weeks after the treatment were all significantly lower than those 1, 2, and 4 weeks after the treatment (all P0.05) in Groups B, D, and E. In Group C the OHP level 2 weeks after the treatment was 0.275±0.031 μg/mg protein, significantly lower than that 1 week after (0.221±0.036 μg/mg protein, P0.05), and the OHP level 8 weeks after the treatment was 0.254±0.039μg/mg protein, significantly lower than those 1, 2, and 4 weeks after (all P0.05). The OH levels 1, 2, and 4 weeks after the treatment of the 4 experimental groups were all significantly higher than that of the control group (all P0.05). 8 weeks after the treatment the level of OHP of Groups B was significantly higher than that of Group A (P0.05), however, the OHP levels of Group C, D, and E had all decreased to almost similar to that of Group A (all P0.05) . (3) The adhesive degrees of Groups C and E were significantly positively correlated with the OHP level (both P0.05), however, the adhesive degrees of Groups B and D were not significantly correlated with the OHP level (both P0.05). The adhesive degrees 1, 2, and 4 weeks after the treatment of the 5 groups were all significantly positively correlated with the OHP levels (all P0.05, however, the adhesive degrees 8 weeks after the treatment of the 5 groups were all not significantly correlated with the OHP levels (all P0.05). (4) The main pathological changes of Group B were foreign body granuloma reaction and fibroplasias in Group B and unspecific inflammatory reaction and fibroplasias in Groups C, D, and E.Conclusion Abdominal adhesions resulting from different causes show different characteristics. The abdominal adhesion caused by foreign bodies and that caused by infection are relatively severe and more difficult to recover than those caused by injury and ischemia. It is more reliable to use OHP level as a marker of abdominal adhesion in the early stage.