羊膜包裹人造骨片修复眼眶爆裂性骨折的实验研究

Experimental study on prevention adhesion after orbital blowout fracture repaired by man-made plates of amniotic membrane

目的探讨羊膜对眼眶爆裂性骨折导致的软组织损伤粘连的预防作用。设计实验性研究。研究对象26只新西兰兔。方法建立兔眼眶爆裂性骨折模型,20只动物右眶通过包裹羊膜的人造骨片进行修复(实验组),左眶直接应用羟基磷灰石(HA)进行修复(对照组),6只动物不进行任何修复(空白对照组)。分别在置入骨片后1周、1个月取骨片周围组织,比较三组的不同。主要指标软组织与骨片间粘连程度分级,组织炎症反应评分,胶原评估,TGF-β免疫组化分析。结果术后1周,HE和免疫组化显示实验组与对照组炎症反应差异无统计学意义(P=0.351,P=0.413),空白对照组与实验组差异有统计学意义(P=0.012,P=0.041);术后1个月,HE和免疫组化显示实验组与对照组炎症反应差异有统计学意义(P=0.037,P=0.048),空白对照组与实验组差异无统计学意义(P=0.285,P=0.472)。结论羊膜包裹人造骨片修复眼眶燥裂性骨折早期未见明显抗炎作用,中晚期则有明显抗炎抗粘连作用。

Objective To explore the effect of preventing adhesion after the orbital blowout fracture on orbit tissue by amniotic membrane. Design Experimental study. Participants Twenty-six New Zealand rabbits. Methods Establishing rabbit orbital blowout fracture model, the right orbit of twenty rabbits was repaired by hydroxyapatite （HA） parceled of amniotic membrane, and left orbit was only repaired by HA, the orbits of the other six rabbits weren＇t repaired. Then we got the tissue around bone after one week and one month, and compared the difference of three groups. Main Outcome Measures Inflammatory response of tissue around bone was analyzed by HE, picric acid Sirius Scarlet dying, TGF-β immunohistochemical observation. Results One week after operation, HE and immunohistochemistry showed that the difference was not significant in inflammatory response between experimental group and control group （P= 0.351, P=0.413）, and difference is significant between blank group and experimental group （P= 0.012, P=0.041）. One month after operation, HE and immunohistochemistry showed that the difference was significant in inflammatory response between experimental group and control group（P=0.037, P=0.048）, and there is no significant difference between experimental group and blank group（P=0.285, P=0.472）. Conclusion It has an important role of anti-inflammatory and anti-adhesion in the chronic stage of inflammatory after orbital blowout fracture repaired by man-made plates of amniotic membrane.