聚L谷氨酸／壳聚糖支架预防椎板切除术后硬膜外粘连  

Prevention of postlaminectomy epidural adhesion by poly L-glutamic acid/chitosan electrostatic complex scaffolds

作　　者：肖治刚[1] 孙文涛[1] 李春波[2] 陈增凎 尹静波[3] 崔磊[1] 

机构地区：[1]上海交通大学医学院附属第九人民医院整形外科,上海200011 [2]复旦大学医学院附属中山医院骨科,上海200032 [3]上海大学高分子材料学院,上海200444

出　　处：《解剖学杂志》2014年第1期67-71,共5页Chinese Journal of Anatomy

摘　　要：摘要目的：探讨聚L谷氨酸／壳聚糖（PLGA／CS）支架预防椎板切除术后硬膜外粘连的效果和机制。方法：通过静电络合法，制备聚L谷氨酸／壳聚糖络合物支架。9只新西兰大白兔随机分为3组，单纯损伤组，切除椎板造成1．5cm×0．8cm椎板缺损区，去除其下硬膜外脂肪；材料组，除损伤与A组相同外，伴有支架植入；正常对照组。术后第1、12、16周行MRI检查，第16周完整取出第6腰椎节段标本，光镜下观察硬膜外瘢痕粘连情况。结果：单纯损伤组硬膜外瘢痕增生明显，侵入椎管，压迫脊髓；材料组硬膜外瘢痕粘连，但未侵入椎管；正常对照组无明显粘连。结论：PLGA／CS支架具有物理和生物学双重预防椎板切除术后硬膜外粘连的作用。Objective： To investigate the effects and mechanisms for the prevention of postlaminectomy epidural adhesion by implantation of composite polymer poly （L-glutamic acid, PLGA） and chitosan （CS）. Methods： PLGA/CS electrostatic complex scaffolds were prepared using electrostatic complex method. 9 New Zealand rabbits in this study were divided into 3 groups randomly. Group A： damaged group （laminectomy was performed in L6 on New Zealand rabbits, and resulted in the status of 1.5 cm×0.8 cm lamina defect, followed by removal of epidural fat）. Group B： materials group （damage similar to Group A, besides, implanted PLGA/CS scaffolds）. Group C： normal control. MRI examination was performed at 1^st, 12^th, 16^th weeks after lamineetomy. The specimens were observed grossly and histologically at 16^th week after lamineetomy. Results： Spinal compression was observed in all the specimens of Group A due to severe epidural adhesion and hyperplastic scar in vertebral canal. Epidural adhesion was formed only in parts of those of Group B, whereas no obvious adhesion in those of Group D. Conclusion： PLGA/CS electrostatic complex scaffolds should have physical and biological effect in preventing postlaminectomy epidural adhesion.

关 键 词：聚L谷氨酸 壳聚糖 硬膜外脂肪 瘢痕 纤维化 

分 类 号：R614.42[医药卫生—麻醉学]