聚-DL-乳酸膜可吸收医用膜在全椎板减压术中的应用价值(附42例疗效与术后MRI表现观察)  

Value of poly-DL-lactic acid absorbable membrane for laminectomy surgery:an observation about the clinical outcome and MRI representation of 42 cases

作　　者：江晓兵[1,2] 张顺聪[1] 姚珍松[1] 梁德[1] 黄伟权[1] 杨志东[1] 丁金勇[1] 晋大祥[1] 

机构地区：[1]广州中医药大学第一附属医院脊柱骨科,广东省广州市510405 [2]广州中医药大学

出　　处：《中国骨与关节损伤杂志》2013年第1期25-27,共3页Chinese Journal of Bone and Joint Injury

摘　　要：目的对比在椎板切除减压术中使用或不使用可吸收医用脊柱膜术后1年临床结果、术后MRI表现的差异,观察其效果及临床安全性。方法 42例行单节段腰椎椎板切除减压的患者随机分为两组:A组在术中使用医用可吸收膜,B组术中不使用医用可吸收膜。结果本组平均随访时间16个月(13～18个月),术后1年根据手术评价标准测定,A组中优16例,良5例;B组中优13例,良8例,两组间疗效优良率比较差异有统计学意义(P<0.05)。术后1年腰痛VAS评分,A组为(1.43±0.49)分、B组为(2.59±0.64)分,两组疗效的优、良例数比较,差异有统计学意义(P<0.05)。术后1年MRI复查发现A组中硬膜囊与周围组织有明显分隔的比例为76.2%、B组为42.9%,两组间差异有统计学意义(P<0.05)。结论聚-DL-乳酸膜可吸收医用膜用于全椎板切除减压时,相比对照组可更好地隔离硬膜与周围瘢痕,可获得更佳的临床效果,临床应用中安全性较高。Objective To compare the difference of clinical outcome and the representation of MRI between the patients treated with or without poly-DL-lactic acid （PDLLA） absorbable membrane after laminectomy surgery. Methods All of 42 patients undergoing monolevel of lumbar total laminectomy and posterior lumbar interbody fusion were randomized to two groups： group A were treated with PDLLA absorbable membrane for intention of preventing peridura scar after decompression, group B were only treated by surgery defined as control group. Results All of patients were followed up, the average period of follow-up was 16 months （13~18 months）. According to the criteria for evaluating surgery effect made by Chinese Orthopedics Association, in group A, there were 16 eases of excellent outcome and 5 cases of good outcome, in group B, there were 13 cases of excellent outcome and 8 eases of good outcome, the rate of excellent outcome was significantly different between these two groups （P 〈0.05）.There was significant difference in VAS of low back pain in 1 year after operation between group A and B, which was 1.43±0.49, 2.59±0.64 respectively （P 〈0.05）. The rate of separation between dura and peridura scar in group A was significantly higher than group B, which was 76.2% and 42.9%, respeetively（P 〈0.05）. Conclusion Poly-DL-lactic acid （PDLLA） absorbable membrane is beneficial to preventing the adhesion between dura and peridura scar and can improve the clinical outcome, its clinical safety is reliable.

关 键 词：椎板切除减压 可吸收防粘连膜 硬膜外瘢痕 

分 类 号：R318[医药卫生—生物医学工程]