不同浓度透明质酸钠防椎管内粘连的对比观察

PAIRED OBSERVATION FOR THE CURATIVE EFFECT OFDIFFERENT CONCENTRATION HYALURONIC SODIUM INPREVENTING INTRASPINAL ADHESION

６０只白兔分为６组，切除Ｌ５全椎板后造成１２ｍｍ×５ｍｍ的硬脊膜裸露区，Ａ组不用任何物质充填，Ｂ、Ｃ、Ｄ、Ｅ、Ｆ组分别充填０．５％，１．０％，１．５％，２．０％和２．５％的透明质酸钠，术后２，４，８周取材行大体、光镜观察和计算机图像分析、结果：Ａ、Ｂ、Ｃ组硬膜外形成致密粘连，Ｄ和Ｅ组粘连较轻，Ｆ组无明显粘连，透明质酸钠浓度与硬膜周围组织中成纤维细胞讨数、硬脊膜发生粘连长度的百分比间存在显著负相关（Ｐ＜０．０１），提示透明质酸钠浓度大于１．５％时才有防椎管内粘连的作用。

Objective: To study the effect of hyaluronic sodium in different concentration for preventing intraspinal adhesion. Methods: 60white rabbits were divided into 6 groups randomly, 12*5mm naked area of dura mater spinalis was made by resecting all L5vertebral lamina. The group A wasn't filled by anything, whereas the group B, C, D, E and F was filled with 0.5%, 1.0%, 1.5%, 2.0%and 2.5% hyaluronic sodium respectively. The relative tissues were taken for general, optical microscopy and computer-assistedimage analysis on the 2nd, 4th and 8th week after the operation respectively. Results: Extradural compact adhesion formed in thegroup A, B and C, lesser intraspinal adhesion formed in the group D and E, and no obvious adhesion occurred in the group F.There was a significant negative correlation between the concentration of hyaluronic sodium, fibroblast counting in the peripheraltissue of scleromeninx and the adhesion length of dura mater spinalis (P<0.01). Conclusions: The results suggest that hyaluronicsodium will have the preventative effect for intraspinal adhesion only while its concentration is more than 1.5%.