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Intraperitoneally administered, hydrogen-rich physiologic solution protects against postoperative ileus and is associated with reduced nitric oxide production. | 高濃度水素生理食塩水の腹腔内投与の術後イレウスの予防効果 ―NO産生減少が関与

2016年8月16日 / 最終更新日時 : 2016年8月16日 kenko_admin その他

Intraperitoneally administered, hydrogen-rich physiologic solution protects against postoperative ileus and is associated with reduced nitric oxide production. | 高濃度水素生理食塩水の腹腔内投与の術後イレウスの予防効果 ―NO産生減少が関与

Surgery. 2016 Jul 14. pii: S0039-6060(16)30201-X. doi: 10.1016/j.surg.2016.05.026. [Epub ahead of print]

Intraperitoneally administered, hydrogen-rich physiologic solution protects against postoperative ileus and is associated with reduced nitric oxide production.

Department of Emergency, Disaster and Critical Care Medicine, Hyogo College of Medicine

Abstract

BACKGROUND:

Postoperative ileus, a transient impairment of bowel motility initiated by intestinal inflammation, is common after an abdominal operation and leads to increased hospital stays and costs. Hydrogen has potent anti-inflammatory and antioxidant properties and potential therapeutic value. Solubilized hydrogen may be a portable and practical means of administering therapeutic hydrogen gas. We hypothesized that intraperitoneal administration of hydrogen-rich saline would ameliorate postoperative ileus.

METHODS:

Ileus was induced via surgical manipulation in mice and rats. The peritoneal cavity was filled with 1.0 mL saline or hydrogen-rich saline (≥1.5-2.0 ppm) before closure of the abdominal incision. Intestinal transit was assessed 24 hours postoperatively. Inflammation was examined by quantitation of neutrophil extravasation and expression of proinflammatory markers. Nitric oxide production was assessed in cultured muscularis propria.

RESULTS:

Surgical manipulation resulted in a marked delay in intestinal transit and was associated with upregulation of proinflammatory cytokines and increased neutrophil extravasation. Bowel dysmotility, induced by surgical manipulation and inflammatory events, was significantly attenuated by intra-abdominal administration of hydrogen-rich saline. Nitric oxide production in the muscle layers of the bowel was inhibited by hydrogen treatment.

CONCLUSION:

A single intraperitoneal dose of hydrogen-rich saline ameliorates postoperative ileus by inhibiting the inflammatory response and suppressing nitric oxide production.

Surgery. 2016 Jul 14. pii: S0039-6060(16)30201-X. doi: 10.1016/j.surg.2016.05.026. [Epub ahead of print]

高濃度水素生理食塩水の腹腔内投与の
術後イレウスの予防効果
―NO産生減少が関与

兵庫医科大学　災害救命救急医療　救急科

＜要旨＞

背景

術後のイレウスは消化管の炎症から始まる腸管運動の短期障害で、腹部手術の後によく起こり、入院日数や費用の増加をもたらします。一方水素は抗炎症作用に加え、抗酸化能を持ち、臨床的価値があるのではないかと言われています。

また、水に溶かした水素は持ち運びに優れ、治療用水素ガスを投与するのと実質的に同等であると考えられます。そこで私たちは高濃度の水素を溶かした生理食塩水を腹腔内投与することで術後のイレウスが緩和するのではないかとの仮説を立てました。

方法

外科手術によりマウスとラットにイレウスを引き起こし、切開した腹部を閉じる前、腹腔に1.0mLの生理食塩水あるいは高濃度水素生理食塩水（≧1.5-2.0ppm）を投与しました。そして術後24時間の腸管通過を観察しました。また、好中球の血管外遊走量や炎症性マーカーの発現を定量することで炎症についても評価しました。なお、NO産生は培養筋層を用いて測定しました。