壳聚糖预防眼外肌手术粘连的实验研究

Study of preventing postoperative musculi bulbi adhesion with chitosan

目的了解壳聚糖预防术后眼外肌粘连的效果,为临床应用提供实验依据。设计自身对照实验研究。研究对象家兔15只(30眼)。方法采用家兔自身对照方法,右眼为实验组,左眼为对照组,分别制作上直肌周围眼球筋膜缺损模型,缺损区实验组用2%壳聚糖凝胶,对照组用平衡盐溶液。主要指标术后4周对术区行大体观察及组织学光镜观察成纤维细胞数目及形态。结果术后4周,大体观察实验组术区组织粘连程度较对照组明显为轻,组织学光镜观察实验组结膜与眼肌组织之间粘连较轻,瘢痕组织增生较少,成纤维细胞数目较少,体积小,排列整齐,较疏松,成熟细胞较少;对照组结膜与眼肌组织粘连重,瘢痕组织增生多,大量成纤维细胞,排列紊乱、密集,多数呈梭形,趋于成熟。结论壳聚糖能减轻眼外肌术后组织粘连,无明显不良反应。

Objective To evaluate the effect of chitosan on preventing postoperative musculi bulbi adhesion. Design Comparative, experimental study. Participants 15 rabbits （30 eyes）. Methods 15 rabbits were adopted self control, left eye was control group and right eye was experimental group. Tenon capsule defect around the superior rectus was made in each eye, but the operation area of experimental group was applied with 2% chitosan gel and balance salt solution （BSS） as control. 4 weeks after the operation, observation of general and microstructure on specimens was noted, and adhesion degrees was classified. Main Outcome Measures 4 weeks after the operation, general and microscopic observation had been done. Results Adhesion degree of experimental group was obviously lower than that of control group, microscopic observation showed there was less scar formation in experimental group, and there was no obvious foreign and inflammation reaction in each group. Conclusion Chitosan is proved to be a good material to prevent musculi bulbi adhesion, and no stimulus to tissue.