摘要
目的:探讨带蒂筋膜脂肪片与玻璃酸钠联合应用预防椎管粘连的可行性。方法:20只大白兔随机分为4组,切除每只动物L_1、L_3、L_5椎板造成3处椎板缺损。A组将玻璃酸钠注于硬脊膜周围后用带蒂筋膜脂肪片覆盖,B组用筋膜脂肪片覆盖,C组仅注玻璃酸钠,D组不用任何间置物覆盖。术后2、4、6、8、12周进行肉眼及光镜观察,并进行硬脊膜粘连程度分级。临床研究申将玻璃酸钠2～4ml注于病人硬脊膜周围后用带蒂筋膜脂肪片覆盖椎板缺损处。结果:术后12周时B、C、D组均形成了致密粘连,A组无粘连发生。157例病人术后随访6～64个月,优良率98.1％。结论:带蒂筋膜脂肪片与玻璃酸钠联合应用,能有效预防椎管内粘连。
Objective To probe the feasibility on prevention of peridural adhesion by the use of fascia-fat piece and sodium hyaluronate(SH). Methods Laminectomy was preformed in lumbar 1, 3 and 5 segment in 20 adult rabbits which were divided into 4 groups. To group A, SH was injected around endorachis, then covered with fascia-fat piece. To group B, coved with fascia-fat piece. To group C, injected with SH only. To group D, covered with nothing. The specimens were observed grossly and tologically at 2, 4, 6, 8 and 12 weeks postoperative. In clinic, 2-4 ml SH was injected around endorachis, then covered with fascia-fat piece on the deficiency of lumbar. Results Severe peridural adhesion were formed in group B, C, D and no adhesion in group A. 157 cases who were treated with this operation ways was foolowed-up 6 -64 months. The good rate is 98.1%. Conclusion Fascia-fat piece and SH have effect in prevention of peridural adhesion after laminectomy.
