聚乙二醇基水凝胶在胃肠道损伤粘合封闭中的应用研究

  在胃肠道疾病治疗中，如肠道癌、溃疡性肠胃炎等常见疾病大多需要通过手术对病变部位进行切除，然后缝合连接剩余的健康组织；胃和肠穿孔则需要对缺损的组织部位进行及时有效的止血和粘合封闭。然而，目前的临床缝合手术存在着手术复杂且耗时较长等缺陷，并且对空腔脏器（胃肠道）和血管丰富的软组织等会造成额外的损伤。医用组织粘合剂具有使用方便、无需拆线且可赋予特定活性功能等优势，是目前外科手术中热门的缝线替代材料。但目前市售的生物医用组织粘合剂仍存在机械强度低、组织粘性差、止血封闭效果不佳和降解产物对人体有害等缺点。因此，开发新型高效且生物安全性能优异的止血医用粘合剂具有重要的研究意义。

  本研究基于课题组已报道的四臂聚乙二醇医用止血密封剂（由末端分别为琥珀酰亚胺活性酯和氨基的四臂聚乙二醇交联得到，缩写为SS胶）， 利用琥珀酰亚胺活性酯与氨基的高反应活性制备得到原位可注射的聚乙二醇水凝胶，进一步探索SS胶在胃部和肠道损伤止血封闭中的应用。研究发现，SS胶在胃肠道表面具有强的组织粘附性，且在胃肠表面模拟扭转、拉伸和弯曲时均具有较好的贴合稳定性。SD大鼠的肠和胃穿孔模型实验进一步表明SS胶对伤口具有优异的止血和组织闭合能力且伤口愈合效果好，无组织粘连现象发生。此外，该SS胶的降解速率与伤口的愈合速率相匹配， 表现出优异的体内生物安全性。

  综上，SS胶具有适用于胃肠道的机械性能、优异的止血封闭能力和良好的生物安全性，可完全满足胃肠道等空腔脏器损伤的使用需求。该SS胶克服了传统生物医用组织粘合剂存在的机械强度低、体内毒性大和使用方法复杂等问题，在临床上具有巨大的潜力和应用价值。

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