不同材料后巩膜加固术的研究

A study of scleral reinforcement materials

目的 为临床开展后巩膜加固术寻找更为理想的手术材料 ,选择用于心血管外科 ,烧伤外科等 4种手术材料进行后巩膜加固手术的实验研究。方法 日本大耳白兔分组用 4种手术材料植入于后巩膜 ,术后 10 ,2 0 ,30 ,6 0 ,90天取标本 ,行大体标本、光镜、透射电镜动态观察。结果 显示异体硬脑膜材料终被自身结缔组织替代 ;人工心包补片逐渐形成植片纤维与自身结缔组织相互交织的组织形态 ;人工血管补片与自身巩膜表面形成潜在腔隙 ;脱细胞异体真皮被结缔组织替代的过程中细胞浸润与胶原组织交替出现。结论 人工心包补片代替生物材料进行后巩膜加固术比较理想 ,脱细胞异体真皮是同种新型生物材料 ,效果将更为理想。

ObjectiveTo select an ideal scleral reinforcement materials,we tested four types that were used in other fields of clinical medicines (homologous dura mater,artificial pericardium,artificial vessel,acellular all dermal matrix).MethodsForty Japanese white rabbits were divided into 4 groups.For each group,one type of material was surgically implanted at the back of the globe.The specimens were harvested at 10,20,30,60,90 d postoperatively and studied by gross examination and light and electron microscopy.ResultsThe homologous dura mater was replaced with connective tissue.The fibers of artificial pericardium were interwoven with connective tissue.There was a gap between artificial vessel and host scleral.Acellular dermis were alternately replaced with connective tissue.ConclusionThe artificial pericardium is an ideal artificial material for post scleral reinforcement material.Acellular dermis will be more ideal as a biological material.