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Abstract
The aim of this study was to develop a hemostatic agent with anti-adhesive properties and to study its effect on liver morphology, metabolic activity and hepatocyte regeneration in experimental liver injury. Methods. In 60 rats following experimental resection liver injury, the time of bleeding and the volume of blood loss were determined. Histological preparations were used to study the size of hepatocytes and their nuclei, the content of glycogen (PAS-reaction), the number of binucleated hepatocytes and the expression of Ki-67. Results. Compared with the control, an agent based on 6% sodium carboxymethylcellulose gel and 5% aminocaproic acid effectively and reliably reduces the bleeding time by 72% (217.91 s), the volume of blood loss by 74.7% (372.85 mg) (p ≤ 0.01) and the degree of blood filling of the sinusoid liver capillaries. In addition, the use of the novel gel prevents the adhesion formation. It stimulates mitotic activity of hepatocytes, accompanied by an increase in the number of binucleated hepatocytes and Ki-67 expression. By the 14th day, this activity significantly decreases. Hypertrophy of hepatocytes and their nuclei is observed by the 7th and 14th days of the experiment. This indicates both an increase in the metabolic activity of hepatocytes and intracellular regeneration. The use of the hemostatic gel does not alter the glycogen-storing function of hepatocytes, which indicates the lack of pronounced hypoxia due to effective control of bleeding. Conclusion. The local hemostatic gel based on 6% sodium carboxymethylcellulose gel and 5% aminocaproic acid can be recommended for local bleeding control in liver injuries and surgery.
Highlights
The aim of this study was to develop a hemostatic agent with anti-adhesive properties and to study its effect on liver morphology, metabolic activity and hepatocyte regeneration in experimental liver injury
Histological preparations were used to study the size of hepatocytes and their nuclei, the content of glycogen (PAS-reaction), the number of binucleated hepatocytes and the expression of Ki-67
An agent based on 6% sodium carboxymethylcellulose gel and 5% aminocaproic acid effectively and reliably reduces the bleeding time by 72% (217.91 s), the volume of blood loss by 74.7% (372.85 mg) (p ≤ 0.01) and the degree of blood filling of the sinusoid liver capillaries
Summary
Исследование кровоостанавливающих свойств нового гемостатического средства проведено в условиях острого эксперимента у 60 самцов крыс линии Вистар массой 185–250 г, содержавшихся в стандартных условиях вивария. Эксперимента, когда размеры гепатоцитов и их ядер оказались достоверно больше в группах с использованием противоспаечного средства и опытного гемостатика по сравнению с контрольной и интактной группами (р < 0,05), что свидетельствует об активизации внутриклеточной регенерации и скорее всего не связано с синтезом белков воспаления, как в контрольной группе. При аппликации исследуемого гемостатического средства численность глыбок гликогена с 3-х по 14-е сутки достоверно не менялась и была больше, чем в других экспериментальных группах, что свидетельствует о сохранности гликоген-зависимых функций гепатоцитов, а следовательно, и об отсутствии выраженной посттравматической гипоксии и структурных повреждений печени. В результате проведенного исследования было установлено, что по сравнению с контролем 6% Na-КМЦ + 5% АК эффективно и достоверно уменьшает время кровотечения на 72% (217,91 с) и объем кровопотери на 74,7% (372,85 мг) (p ≤ 0,01), а также уменьшает степень кровенаполнения синусоидных капилляров печени. Применение средства позволяет избежать значительных нарушений гликоген-запасающей функции печени, в определенной степени стимулирует метаболическую активность гепатоцитов, сопровождается более ранней контролируемой активацией митотической функции гепатоцитов после травмы
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