脑膜修补材料的应用基础研究

Labaratory study and clinical application of dural substitutes

自1978～1990年间对胎儿硬脑膜,尼龙硅胶膜,猪腹膜进行动物实验研究并将特制猪腹膜,尼龙硅胶膜,颅骨骨膜颞肌筋膜及自体硬脑膜应用于临床。发现:光镜下及电镜下各种修补材料的基本结构大致相同,即在致密整齐或疏松紊乱的胶原纤维支架上,夹杂有少量成纤维细胞及增生血管,其基本特征与正常人硬脑膜相似,无明显的组织排异反应或变性坏死。本文着重探讨排异反应、脑膜脑粘连,癫痫,脑机能障碍及颅内感染等有关问题,并提出选择和设计脑膜修补材料的四个要点。

From 1978 to 1990,labaratory study and clinicalapplication of dural substitutes were carried out.Dif-ferent materials were used.There were frozedried hu-man dural mater gama ray sterilized soaked human du-ral mater,silica gel-film,speciallymade porcine peri-toneum,human periosteum,temporal fascia,and au-tologous fresh dural mater.Under the observation oflight and electron microscope we found main structureof all kinds of substitutes consisted of a collagen fibernetwork mingled with some bibro-cyte and neoformed vessels.It was similar to that of human dural mater.No obvious tissue rejection and serious degeneration,necrosis occured.Some factors relating to tissue rejec-tion,meningocerebral adhesions,epilepsy,neurologi-cal deficits and intracranial infection were discussed.