兔非穿透性滤过手术联合壳聚糖膜植入的远期效果  

Long-term effect of nonpenetrating filtering surgery with chitosan membrane implantation in rabbits

作　　者：李洁[1] 李晓陵[2] 黄一飞[2] 胡平[3] 

机构地区：[1]武警北京总队医院眼科,中国北京市100027 [2]解放军总医院眼科,中国北京市100583 [3]清华大学化工系,中国北京市3100084

出　　处：《国际眼科杂志》2006年第3期584-586,共3页International Eye Science

摘　　要：目的:观察壳聚糖膜在动物非穿透性滤过手术(NPFS)中应用的组织反应以及远期降眼压效果。方法:壳聚糖膜来源于雪蟹壳。选取标准新西兰白兔22只44眼,雌雄兼用,单眼行NPFS(非穿透性滤过手术)联合壳聚糖膜植入作为实验组(A组),另眼单纯行NPFS作为对照组(B组)。术后观察眼压、炎症反应、结膜滤泡。并分别于1,4,12,28,36,40,48wk取标本行组织学检查。结果:术前两组眼压无显著性差异(P>0.05)。不同时间点两组术后眼压与术前眼压相比均有显著性差异(P<0.01),不同时间点两组之间术后眼压相比均有显著性差异(P<0.01)。超声生物显微镜检查:术后不同时间点两组均维持手术腔隙。A组术后36wk植入物部分吸收,植入材料有断裂现象。B组手术处可见组织间隙存在,但较手术早期减压腔隙减小。组织学检查:两组术后中性粒细胞数无显著性差异(P>0.05),成纤维细胞和嗜酸性细胞数有显著性差异(P<0.01)。术区总胶原纤维及Ⅰ、Ⅲ型胶原纤维含量有显著性差异(P<0.01)。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。AIM： To evaluate effects of chitosan membrane on nonpenetrating filtrating surgery （NPFS） in rabbits. METHODS： Chitosan membrane was extracted from the shell of snow-crab. Twenty-two New Zealand albino rabbits （44 eyes） were divided randomly into 2 groups： 22 eyes were used in group A and B respectively. The NPFS was performed in both group A and B, and chitosan implant was used only in group A. Clinical observation was performed including wound healing, inflammatory reaction, filtering and IOP. Pathological examination were taken from two eyes in each group at 1, 4, 12, 28, 36, 40 and 48wk, respectively. RESULTS： IOP： no obvious side effects were noticed in group A and B before surgery （P〉0.05）, but there were obvious different effects at different time points in each group and between group A and B （P〈0.01）. UBM examination showed that the operating space was noticed in group A and B after surgery. At 36wk, partial fracture and absorption of chitosan implant was noticed and the space was small in group B. Histology observation： there was no significant statistical difference in the numbers of neutrophil between group A and B after surgery （P〉0.05）. The numbers of phoroblast and eosinophil was noticed in two groups （P〈0.01）. The percentage of total collagen and type-Ⅰ collagen and type-Ⅲ collagen was significant statistical difference （P〈0.01）. CONCLUSION： Chitosan may effectively decrease IOP of animals and is suitable material for NPFS implants.

关 键 词：壳聚糖 非穿透性滤过手术 兔 

分 类 号：R779.6[医药卫生—眼科] R318.08[医药卫生—临床医学]