壳聚糖类鼻腔填塞止血材料的研究与制备

发布时间：2018-06-16 23:13

本文选题：鼻腔填塞 + 止血材料　；参考：《北京化工大学》2015年硕士论文

【摘要】：在我国有大量人群受到鼻炎、鼻息肉等鼻部问题的困扰,环境污染加剧,空气状况不佳等外界刺激更易使患者病况恶化,目前鼻内镜手术是解决鼻部疾病的有效手段。鼻内镜手术的成功与否与鼻腔填塞止血材料密切相关,性能欠佳的鼻腔填塞止血材料容易导致填塞失败,增加患者在填塞止血阶段的痛苦,并有可能导致复杂的综合并发症。当下国内耳鼻喉科临床实践中使用的优质填塞止血材料多为国外产品,即使这些国外产品,也存在诸如生物亲和性差、降解物对人体有害或不能在人体内降解以及价格昂贵等多方面的问题,而国内的鼻腔填塞止血材料性能普遍欠佳,因此开发性能良好的国产鼻腔填塞止血材料十分必要。羧甲基壳聚糖(CMCS)已被证明是具有良好医药应用潜力的生物材料,但其泡沫材料存在较脆、易溶解以及易在人体内残留等问题。本文尝试使用柔性高分子材料对CMCS进行改性,特别是对其进行增韧改性。文中选择了聚乙二醇(PEG)和聚乙烯醇(PVOH)分别对CMCS进行共混改性。(1)对实验中所有的原料CMCS进行测定,主要测定选用的壳聚糖、羧甲基壳聚糖的水分、溶解性能、脱乙酰度、数均分子量等理化性质。测定结果表明,所选用的CMCS的分子量为约为15万;脱乙酰度约90%,；羧甲基壳聚糖的羧甲基度约为94%；原料壳聚糖以O-羧甲基壳聚糖为主。(2)尝试使用PEG对CMCS进行改性,对制备得到的PEG/CMCS复合材料进行性能测试,测试结果表明该复合材料适用于普通鼻腔出血止血,不适用于ESS手术后。(3)尝试用PVOH对CMCS进行改性,以CMCS和PVOH为原料制备得到系列PVOH/CMCS海绵材料,并进行了性能测试。测试结果表明,PVOH/CMCS海绵材料孔径分布均匀,吸水率较高,并且随着PVOH用量的增加,复合材料的吸水率也随之增加,最高吸水率是材料自重的十倍；对这种复合材料力学性能的测定表明在引入PVOH后壳聚糖海绵材料韧性显著提升,样品的拉伸强度虽然有所下降,但实验样品的断裂伸长率能够有显著的提升,拉伸强度下降三分之一断裂伸长率增加三倍左右,PVOH起到了增韧CMCS止血海绵的作用；PVOH的引入,对CMCS材料的降解时间影响不大,PVOH/CMCS复合材料的降解时间主要受到其中CMCS组分的影响。(4)合作单位用PVOH/CMCS复合材料实施了动物实验,对生物相容性和止血效果等进行了测定。实验结果表明,认为这种材料安全无毒,生物相容性良好；该材料不适用于体内填充止血；能够在实验机体内部分降解,降解产物无毒害,能够被机体吸收；制备的PVOH/CMCS止血海绵填塞成功率较高,抽取十分方便；与纳西棉止血海绵相比,本产品在填塞成功率、止血效果等方面占优。
[Abstract]:In China, a large number of people are troubled by nasal problems such as rhinitis, nasal polyps, environmental pollution, poor air conditions and other external stimuli are more likely to make patients worse. At present, nasal endoscopic surgery is an effective means to solve nasal diseases. The success of endoscopic sinus surgery is closely related to the nasal packing and hemostatic materials. The poor performance of nasal packing and hemostatic materials can easily lead to the failure of packing, increase the pain of the patients at the stage of packing and hemostasis, and may lead to complex complications. At present, the high quality packing and hemostatic materials used in the clinical practice of otolaryngology in China are mostly foreign products. Even these foreign products have poor biological affinity. Degradation is harmful to human body or can not be degraded in human body, and the price is expensive. However, the performance of nasal packing hemostatic material is generally poor in China, so it is necessary to develop domestic nasal packing hemostatic material with good performance. Carboxymethyl chitosan (CMCS) has been proved to be a biomaterial with good potential for medical application, but its foam materials are brittle, soluble and easily residual in human body. In this paper, flexible polymer materials are used to modify CMCs, especially to toughen CMCs. In this paper, polyethylene glycol (PEG) and polyvinyl alcohol (PVOH) were used to modify CMCs respectively. All the raw materials CMCs were determined. The water content, solubility, deacetylation degree of chitosan and carboxymethyl chitosan were determined. Number average molecular weight and other physicochemical properties. The results show that the molecular weight of the selected CMCs is about 150000; the degree of deacetylation is about 90; the carboxymethyl chitosan is about 94; the raw material chitosan is mainly O- carboxymethyl chitosan. The properties of the prepared PEG / CMCS composite were tested. The results showed that the composite was suitable for hemostasis of common nasal cavity and not suitable for the treatment of ESS after operation.) PVOH was used to modify CMCS. A series of PVO / CMCS sponge materials were prepared from CMCs and PVOH, and their properties were tested. The results show that the pore size distribution of PVOH / CMCS sponge is uniform and the water absorption rate is high. With the increase of PVOH content, the water absorption rate of the composite also increases, and the maximum water absorption rate is 10 times of the weight of the material. The mechanical properties of the composite showed that the toughness of chitosan sponge increased significantly after the introduction of PVOH, and the tensile strength of the sample decreased, but the elongation at break of the experimental sample increased significantly. The decrease of tensile strength by 1/3 and the increase of elongation at break by about three times increased the effect of PVOH on toughening CMCs hemostatic sponge and the introduction of PVOH. The degradation time of PVOH / CMCS composite was mainly affected by the CMCS component. The co-workers carried out animal experiments with PVOH / CMCS composite, and the biocompatibility and hemostatic effect were measured. The experimental results show that the material is safe and non-toxic and has good biocompatibility, which is not suitable for filling and hemostasis in vivo, and can be partially degraded in the experimental organism, and the degradation product is non-toxic and can be absorbed by the body. Compared with Naxi cotton hemostatic sponge, the success rate and hemostatic effect of PVOH / CMCS were better than that of Naxi cotton hemostatic sponge.
【学位授予单位】：北京化工大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R318.08

【参考文献】