腸管癒着防止法に関する実験的研究 特にオロチン酸クロロキン液(キドラ)の癒着防止効果について
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Many studies have been performed on prevention of adhesion in the abdominal cavity for a long time, but few are satisfactory. The author noticed kidola solution (chloroquine diorotate) in May, 1963 because of its activity to prevent growth of fibroblasts, and anti-allergic and anti-inflammatory activities. Thus, the author tried to prevent adhesion of the intestinal tube using the said solution.<BR>Male healthy adult rabbits of the weight of 2.0-2. 5 kg. were selected for the experiments ; by peeling the serous membrane near the end of the ileum off, adhesion could be successfully produced widely and tightly in all the cases, For the purpose to prevent the said adhesion, 1 % and 2 % kidola solution, 1 % chondron solution (chondroitin sulfate), plasgen solution (7 % polyvinyl pyrrolidon), kimopsin solution (chymotrypsin) were employed.<BR>They were administered by (A) infusing into the abdominal cavity, (B) injecting and (C) infusing into the abdominal cavity simultaneously to injecting. Infusion consisted of single solution infusion and solution mixture infusion ; injection was classified into the intramuscular injection and the intravenous one. The result of adhesion prevention was determined optically and histologically.<BR><I>Results</I>: Among the A Class, the group administered 50 mg/kg of 2 % kidola solution only showed the best result. There was observed no difference between the single solution infused group and the solution mixture infused one.<BR>As to the B class, 5 units/kg. of kimopsin solution was injected intramuscularly every day for 3 days and 5 mg/kg of 1 % kidola solution was injected intravenously for 3 days. There was observed on difference between the above two methods. Single solution infusion was superior as to the both solutions. Some cases showed bleeding in the abdominal cavity with kimopsin either by infusing or by injecting.<BR>The C class was much better than A and B classes ; above all, the group to which 50 mg/kg of 2 % kidola solution was infused, followed by intravenous injection of 50 mg/kg of 1 % kidola solution every day for 3 days showed the best result among the experiments.<BR>Experiments for preventing re-adhesion after peeling the intestinal adhesion were carried out on rabbits. The used solutions were the above 4 solutions except kimopsin. They were given similarly as in the previous experiments.<BR><I>Results</I>: Among the A'class, the group administered 50 mg/kg of 2 % kidola solution got the best result ; however, comparing with the previous result of the A class, it was poorer. The result of the solution mixture infused group was much poorer.<BR>The B'class was given only 1 % kidola solution. A group was administered 5 mg/kg of the solution intravenously every day for 4 days, and another group was given the same dose every day for 14 days. The group of the longer injection period showed the better result to prevent the adhesion.<BR>The result of the C'class was better than the A'class's and B'class's. Above all, the two groups administered 5 mg/kg of 1 % kidola solution intravenously every day for 3 days after infusing 50 mg/kg of 2 % kidola solution or after infusing 50 mg/kg of 1 % kidola solution showed good results.<BR>From the above experimental results, it was recognized that kidola solution was much superior in preventing adhesion to other solutions. It is said, however, that side-effects of chloroquine are observed usually with a prolonged administration to bring forth symptoms indigestive organs, optical organs, and nervous systems. According to a recent report, it is pointed out that when injecting chloroquine to an anesthesthetized dog, intravenously, the motoric muscles sometimes began to loose to cause insufficient respiration : but there is also clarified that vagostigmin is sufficiently against the muscular looseness. In the experiments on rabbits performed by the author, such side-effects were not recognized.
- 昭和大学・昭和医学会の論文