二氧化碳激光焊接修补小型猪硬脑膜缺损  

Carbon dioxide laser soldering for dura reconstruction in minipig models

作　　者：王振民[1] 钟红亮[2] 杨智君[1] 赵赋[3] 王博[1] 渠沛然[1] 王兴朝[1] 刘丕楠[1,3] 

机构地区：[1]首都医科大学附属北京天坛医院神经外科,100050 [2]首都医科大学附属北京朝阳医院神经介入科,100020 [3]北京市神经外科研究所

出　　处：《中国微侵袭神经外科杂志》2013年第3期133-135,共3页Chinese Journal of Minimally Invasive Neurosurgery

基　　金：北京市自然科学基金(编号:7112049);北京市卫生系统高层次卫生技术人才(编号:2011-3-027);国家科技支撑计划(编号:2012BAI12B03)

摘　　要：目的探讨二氧化碳(CO2)激光焊接法修补硬脑膜缺损的有效性和安全性。方法 12头巴马小型猪随机等分成两组,双额顶开颅并造成约1 cm×2 cm的硬脑膜缺损,自体颞肌筋膜修补。实验组采用CO2激光焊接法,对照组使用纤维蛋白胶黏和法。术后15 d检测修补硬脑膜的水密性,测爆裂压力,并对其进行组织学分析。结果两组动物术后均存活,无并发症。实验组重建硬脑膜均水密性良好,对照组水密性良好5例,1只动物修补位置出现脑脊液渗漏,未完成爆裂压力测试。实验组平均爆裂压力(170.12±30.03)mmHg,对照组(103.60±13.78)mmHg,两组差异有统计学意义(P<0.01)。显微镜下两组硬脑膜标本的炎症反应无明显差异,修补硬脑膜下脑组织形态正常。结论 CO2激光焊接重建硬脑膜水密性好、组织强度高、炎症反应轻、无副损伤,是可供选择的硬脑膜重建技术。Objective To explore the feasibility and safety of dural repair by carbon dioxide （CO2） laser soldering in minipig models. Methods Twelve Bama minipigs were randomly and equally divided into two groups. The craniotomy with a dural defect about 1 cm × 2 cm was performed in the bilateral frontal-parietal region in all the animals. The dural defect was repaired by conventional fibrin bonding in control group and CO2 laser soldering in experiment group with autologous temporalis fascia. The water tightness was examined and burst pressure of the repaired dura was measured on the 15th day after surgery. Moreover, the specimens were also subjected to histological analysis. Results All the animals survived without any complications. All the animals achieved well watertight repair in experimental group and 5 in control group, and cerebrospinal fluid leakage occurred in 1 in control group, which did not complete detection the burst pressure of the repaired dura. The mean burst pressure was 170.12 ± 30.03 mmHg in experimental group and 103.60 ± 13.78 mmHg in control group, and significant difference was found between the two groups （P 〈 0.01）. There was no difference in inflammatory reaction between the two groups with a normal morphology of subdural brain tissue under microscope. Conclusion CO2 laser soldering can be an alternative technique for dural repair with good water tightness, sufficient tissue strength, lower inflammatory reaction and little side-injury.

关 键 词：硬脑膜重建 二氧化碳激光 焊接 猪 雏型 

分 类 号：R651.1[医药卫生—外科学]