聚乙丙交酯膜预防硬膜外瘢痕粘连的实验研究

PLGA membrane in prevention of epidural scar adhesions after the operations:an empirical study

目的观察新型生物可吸收材料聚乙丙交酯(poly lactate glycollic acid,PLGA)薄膜预防椎板切除术后硬膜外瘢痕粘连的作用,并与临床常用的明胶海绵进行比较。方法36只成年新西兰雄兔切除L6(第6腰椎)椎板,制作椎板切除模型,在椎板缺损处分别覆盖PLGA膜(A组)、明胶海绵(B组)、0.9%生理盐水(C组)。术后每日观察动物的一般情况,第2、48、周每组各处死四只,取标本行大体、组织学观察,术后2、4周同时行超微结构观察。结果与对照组相比,PLGA膜可以明显减轻术后硬脊膜与硬膜外瘢痕之间的粘连;明胶海绵不能减轻硬膜外瘢痕粘连。结论PLGA膜能有效减轻硬脊膜与硬膜外瘢痕之间的粘连而不影响刀口的愈合,临床应用前景广阔。

Objective To explore the prophylactic function of a newly produced, absorbable PLGA membrane in the prevention of epidural scar adhesions after laminectomy. Methods 36 adult New Zealand male rabbits which had undergone resection of the L6 vertebral plates were divided them into 3 groups： the defects of vertebral plate were covered with PICA membrane （group A）, gelatin sponge （group B） and saline sohition （group C）. Morphological changes of the scar were grossly and histologically observed on week 2, 4 and 8 after the operations, and also the ultra-structures were observed. Results Compared with the blank group, the PLGA membrane obviously reduced epidural adhesions; at an early stage, the gelatin sponge formed a physico-barrier, which lessened the epidural sear formation, as well as the PLGA membrane, but it latter made the adhesions even worse. Conclusion The PLGA membrane can lessen epidural scar adhesions without interfering in cutting edge healing.