摘要
背景:对椎板切除术后硬膜外瘢痕与神经根粘连的预防目前多采用术中局部放置各种隔离材料或术后应用药物控制炎性反应。目的:观察几丁糖-钛网联合运用对防治硬膜外瘢痕粘连形成的作用。设计、时间及地点:随机对照动物实验,于2005-06/12在贵阳医学院完成。材料:成年家兔80只,体质量(2.0±0.2)kg,用于制作椎板切除模型;几丁糖为上海其胜生物制剂实业公司产品;钛网由贵州科伦药业有限公司提供。方法:将80只成年兔随机摸球法分为4组,对照组:予生理盐水覆盖(0.5mL);钛网组:用1.0cm×0.8cm钛网模拟椎板成型后覆盖于椎板缺损处,缝合固定于上下锥体棘突与两侧肌肉及软组织上;几丁糖组:植入2mL医用几丁糖;几丁糖+钛网组:联合运用钛网和几丁糖凝胶。分别在术后第2,4周处死6只,8周时取8只家兔做标本。主要观察指标:动物瘢痕形态学的改变。结果:对照组瘢痕日趋明显;钛网组可减轻硬膜周围的瘢痕包裹,有效的隔绝周围瘢痕组织与硬脊膜;几丁糖组有明确的抗瘢痕粘连、抑制炎症反应的作用;几丁糖+钛网组能有效抑制硬膜周围瘢痕的增生。结论:几丁糖-钛网联合运用能有效抑制椎板切除术后硬膜周围的瘢痕粘连。
BACKGROUND： Presently, it is a certain preventive effect of local emplacement of various isolated materials during operation and postoperatively drug-controlled inflammatory reaction on adhesion between epidural and nerve root after laminectomy. OBJECTIVE： To study the preventive effect of chitosan and titanium net on epidural cicatricle adhesion after laminectomy. DESIGN, TIME AND SETTING： Randomized controlled animal study, which was performed in Guiyang Medical College from June to December 2005. MATERIALS： Eighty adult rabbits, weighing （2.0 ±0.2） kg, were used to establish vertebral plate resection models. Chitosan was provided by Shanghai Qisheng Biological Agent Industry Company, and titanium net by Guizhou Kelun Pharmacology Company Limited. METHODS： Eighty adult rabbits were randomly divided into four groups, including control group （0.5 mL saline）, titanium net group （titanium net in the size of 1.0 cm × 0.8 cm was covered on defect region of vertebral plate and fixed on processus spinosus of upper and lower cone, bilateral muscles and soft tissues）, chitosan group （2 mL chitosan）, and chitosan ＋ titanium net group （combination of chitosan and titanium net）. Six rabbits were sacrificed in the 2nd and 4th weeks postoperatively, and eight rabbits were chosen as the samples in the 8th week. MAIN OUTCOME MEASURES： Morphological changes of cicatricle. RESULTS： Cicatricle was clearer in the control group. Titanium net could relieve peripheral cicatricle of dura mater and effectively isolate peripheral cicatricial tissue and spinal dnra meter. Chitosan could remarkably prevent from cicatricle adhesion and inhibit inflammatory reaction. The combination of chitosan and titanium net could effectively inhibit proliferation of cicatricle surrounding dura meter. CONCLUSION： Association of chitosan and titanium net can effectively inhibit cicatricle adhesion surrounding dura meter after laminectomy.
出处
《中国组织工程研究与临床康复》
CAS
CSCD
北大核心
2008年第45期8992-8996,共5页
Journal of Clinical Rehabilitative Tissue Engineering Research
基金
Guizhou Governor's Foundation,No.200524~~
