椎板切除神经根损伤后聚羧甲基葡萄糖胺产品抗瘢痕粘连的效果

Effect of A Chitosan Product on Scarring and Adhesion of Injured Nerve after Laminectomy

目的探索聚羧甲基葡萄糖胺产品防止神经损伤后瘢痕粘连形成的效果。方法 48只雄性Sprague-Dawley大鼠分为A、B两组。大鼠切除L4-5椎板,暴露并损伤右侧神经根。A组术区涂抹生理盐水,B组涂抹聚羧甲基葡萄糖胺产品。术后第1(A1、B1)、2(A2、B2)、4周(A3、B3)对各组神经根周围粘连行Rydell评分;HE染色、Masson染色观察,行粘连组织学Nussbaum评分;检测血常规和肝、肾功能。结果各组Rydell评分:A1组Ⅰ级、A2组Ⅱ级、A3组Ⅲ级,B1组0级、B2组0级、B3组Ⅱ级。HE染色示B组较A组神经根周围粘连速度慢且瘢痕生长疏松。Masson染色示B组较A组神经根周围瘢痕组织网稀疏散在,且随时间延长其致密程度加深不明显。组织学Nussbaum评分示,同时段A、B组间比较均有显著性差异(P<0.05)。各组大鼠血常规及肝、肾功能均在正常参考值范围内。结论聚羧甲基葡萄糖胺产品能有效防止椎板切除术后神经根周围及硬膜外瘢痕粘连形成,无毒副作用。

Objective To investigate the effects of a chitosan product on scarring and adhesion after never injury in laminectomy in rats. Methods 48 male Sprague-Dawley rats were divided into group A and group B, and carried laminectomy of L4-5, and injured the right spinal nerve roots. The normal saline was smeared on the operation field in the group A, while the chitosan product was smeared in the group B. The adhesion was assessed with Rydell score 1 （groups A1/B1）, 2 （groups A2/B2） and 4 （groups A3/B3） weeks after operation, while the spi-nal nerves were observed with HE staining and Masson staining, and the adhesion was assessed with Nussbaum score. The complete blood count and the series of blood chemistries and enzymes for liver and kidney functioning were measured. Results The Rydell scores of adhe-sion was I grade in group A1, II grade in A2 and III grade in A3, while was 0 grade in B1, 0 grade in B2 and II grade in B3. The scar and ad-hesion contact more loosely in the group B than in the group A, and the Nussbaum score was less in the group B than in the group A at the same time （P〈0.05）. The complete blood count and the series of blood chemistries and enzymes for liver and kidney functioning were in nor-mal. Conclusion This chitosan product can prevent the formation of epidural scar and adhesion around the spinal and the nerve roots after laminectomy, with little toxicity and side effects.