选择性脊神经后根切除术椎板切除后硬膜外防粘连的实验研究  

The effect of chitosan in prevention of fibrous scar tissue formation after laminectomy

作　　者：王秋根[1,2] 项耀钧[1,2] 侯春林[1,2] 吴岳嵩[1,2] 杨锡铭[1,2] 顾雄华[1,2] 徐卫东[1,2] 康一凡[1,2] 

机构地区：[1]第二军医大学附属长海医院骨科 [2]第二军医大学附属长征医院骨科

出　　处：《中华外科杂志》1998年第6期379-381,共3页Chinese Journal of Surgery

基　　金：国家自然科学基金

摘　　要：目的观察选择性脊神经后根切除术（ＳＰＲ）椎板切除后硬膜外几种防瘢痕粘连物质的作用并探讨其机制。方法用４８只ＳＤ大鼠制作硬膜外周围粘连模型，在损伤的硬膜表面分别涂布透明质酸钠、自体游离脂肪、几丁糖、生理盐水，分别于４、８、１２周观察瘢痕形成情况并测定胶原纤维含量。结果生理盐水组大鼠硬膜外瘢痕自第４周开始形成，于第８周达高峰，１２周时开始软化、收缩；透明质酸钠与几丁糖预防瘢痕形成均有明显效果，其中几丁糖明显优于透明质酸钠；组织相容性以自体游离脂肪最好，其次是几丁糖、透明质酸钠。结论几丁糖对硬膜外周围瘢痕形成。Objective To study the effect of chitosan in the prevention of fibrous scar formation in the epidural space after laminectomy. Method Fourty eight SD rats were used as the animal model. Laminectomy was performed in lumber 1,and the exposed dura was covered with hyaluronate(group A),free fat(group B),chitosan(group C),and saline solution(group D)respectively. At 4,8 and 12 weeks postoperation, scar formation was observed. Result The results revealed that scar formed in the group D at the fourth week reached a peak at the eighth week and began to soften and constrict at the twelfth week. Sodium hyaluronate and chitosan had a significant efficacy in the prevention of scar formation, but the effect of chitsan was superior to that of sodium hyaluronate. Conclusion The findings of this study indicate that chitosan has a preventive effect on scar tissue formation.

关 键 词：椎板切除术 硬膜外 粘连 预防 SPR 

分 类 号：R651[医药卫生—外科学] R619.01[医药卫生—临床医学]