壳聚糖膜在青光眼非穿透滤过手术中应用的动物实验

Chitosan membrane on nonpenetrating filtering in rabbits

目的 :观察壳聚糖膜在动物非穿透性滤过手术中应用的组织反应以及降眼压效果等。方法 :壳聚糖膜来源于雪蟹壳。新西兰大白兔 18只 36眼 ,随机分为三组 ;A、B组各 15只眼 ,C组 6只眼 ;A组行NPFS联合壳聚糖膜巩膜瓣下植入 ,B组单纯行NPFS ,作为手术对照 ,C组 6只眼不做手术 ,为正常对照。术后观察眼压、炎症反应、结膜滤泡等。并分别于 1,2 ,4,10 ,2 0周取标本行组织学检查。结果 :术前各组平均眼压为 (4 2 7± 0 0 7)kPa ,术后 2 0周A组平均眼压为 (1 93± 0 30 )kPa ,B组平均眼压为 (3 5 2± 0 5 6 )kPa,C组平均眼压为 4 4 0kPa ,三组之间有显著性差异 (P <0 0 5 )。A、B、组术后 10周炎性反应基本消失 ,两组无差异。A组 2 0周植入物无明显吸收 ,但植入材料有断裂现象 ,其周围有组织间隙和滤泡存在 ,无明显纤维组织增生 ,B组组织结构基本恢复正常 ,稍有紊乱 ,未见组织间隙和滤泡。A、B两组嗜酸性粒细胞差异有显著性 (P <0 0 5 )。结论 :壳聚糖作为非穿透性滤过手术的植入材料有良好的组织相容性、有一定抑制纤维组织增生的作用 ,能够有效维持滤过 ,降眼压效果满意。

Objective:To evaluate effects of chitosan membrane on nonpenetrating filtrating surgery (NPFS) in rabbits.Methods: Chitosan membrane extracted from shell of snow-crab was made. New Zealand albino rabbits were 18 cases (36 eyes) were divided randomly into 3 groups, and 15 eyes were used in group A, B respectively, and C group 6 eyes without surgery were used for normal control. The NPFS was performed in group A and B. Chitosan implant was used in group A . Clinical observation was performed including wound healing, inflammatory reaction, filtering and IOP. Pathological examination were taken from two eyes each group at 1,2,4,10 and 20 weeks, respectively. Results: During experiment, no obvious side effects were noticed in group A and B. Mean value of normal IOP was (4.27±0.07) kPa. Pathological examination showed that the chitosan implant was well biocompatible and there was no obvious absorption at 10 weeks. Partial fracture and absorption of chitosan implant was noticed at 20 weeks. Conclusion: Chitosan may decrease effectively IOP for animals and was suitable materials for NPFS implants.