几丁糖-钛网联合运用防治椎板切除术后瘢痕粘连的实验研究与临床应用初探

Association apply of chitosan and titanium net prevente cicatricle accretion after laminectomy

目的通过观察椎板切除术后硬膜外瘢痕粘连的形态学改变,探讨几丁糖-钛网联合运用对防治硬膜外瘢痕粘连形成的作用。方法用80只成年家兔(体重2±0.2 kg)制作椎板切除模型,在椎板缺损处分别覆盖等渗盐水(A组)、钛网(B组)、几丁糖(C组)及几丁糖加钛网(D组),分别于2、4、8用在电镜与光镜下观察瘢痕形态学的改变。结果对照组瘢痕明显,钛网组可减轻硬膜周围的瘢痕包裹,有效地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,几丁糖加钛网组能有效地抑制硬膜周围瘢痕的增生。结论几丁糖加钛网能有效地抑制椎板切除术后硬膜周围的瘢痕粘连。

Objective To observe the morphology changes of epidural cicatricle accretion following laminectomy, and the effect of association apply of chitosan and titanium net in preventing its formation. Methods Eighty rabbits were operated for the laminectomy in this study and were divided into 4 groups： the defects of vertebral plate were covered with saline solution （group A）, net of the titanium （group B）, chitosan （group C） and intergrated chitosan and net of the titanium （group D）. The morphology changes of scars were observed by electron microscope and light microscope on 2,4 and 8 weeks after operated. Results The scar formation was obvious in group A. Net of the titanium can reduce the scar formation, and isolate it endorachis effectively. Chitosan can prevent the cicatricle accretion and stop the inflammatory reaction significantly. However intergrated Chitosan and net of the titanium has a three--dimensional prevention of the scar hyperplasy. Conclusion Chitosan and net of the titanium has a three-dimensional prevention of the scar hyperplasy after aminectomy.