几丁糖联合聚乳酸薄膜预防硬膜外粘连的研究

目的 观察几丁糖加聚乳酸薄膜联合运用对椎板切除术后预防硬膜外瘢痕粘连的效果.方法 80只成年家兔体质量(2.0±0.2)kg]制作椎板切除模型,在椎板缺损处分别覆盖等渗盐水(A组)、聚乳酸薄膜(B组)、几丁糖(C组)及几丁糖加聚乳酸薄膜(D组),术后12周对椎板切除部位进行大体观察、组织学观察及透射电镜比较各组间瘢痕形成和粘连情况.结果 B、C、D组的Rydell-Balazs粘连度评分、Nussvaum组织学评分均优于A组(P<0.01),D组优于B组和C组(P<0.01),B组与C组间差异无统计学意义(P>0.05).结论 联合应用几丁糖加聚乳酸薄膜能有效预防硬膜外瘢痕粘连,比单独应用几丁糖或聚乳酸薄膜效果好.

Prevention of epidural adhesion after laminectomy by combined use of chitin with polylactic acid membrane

Objective To observe the preventive effect of chitin combined with polyactie acid membrane (PLA) on epidural adhesion. Methods Eighty rabbits were subjected to the laminectomy and divided into 4 groups: The defects of vertebral plate were covered with saline solution ( group A ), PLA (group B), chitin (group C), and chitin combined with PLA (group D). The morphology, histology and transmission electron microscope observations of the operated space were carried out at the 12th week post-operatively. Results Both RydelI-Balazs score and Nnssvaum score in groups B, C, and D were obviously higher than those in group A (P <0.01 ) ,the effect of group D was better than that of groups B and C (P < 0.01 ),but there was no singificant difference between groups B and C (P > 0.05 ). Conclusion Application of chitin combined with PLA has a better preventive effect on epidural adhesion after laminec-tomy than use of chitin or PLA alone.