可吸收隔囊预防硬膜外粘连的初期疗效观察  

Earlier effects of absorbable spacing bag in prevention of epidural adhesions

作　　者：庄苏阳[1] 蒋建农[2] 吴小涛[1] 郝思春[2] 

机构地区：[1]东南大学附属中大医院脊柱外科,江苏南京210009 [2]宜兴市人民医院骨科,江苏宜兴214200

出　　处：《东南大学学报（医学版）》2014年第4期449-452,共4页Journal of Southeast University(Medical Science Edition)

基　　金：无锡市卫生系统指令性科研基金资助项目(XM1007)

摘　　要：目的:探讨可吸收隔囊预防全椎板减压术后硬膜外粘连的初期疗效。方法:选用11只新西兰纯种考力代羊,根据椎板切除术后硬膜外局部处理方法不同分为可吸收隔囊组(隔囊组)、聚己内酯/聚乳酸膜组(隔膜组)、对照组(局部仅应用生理盐水)。将11只羊进行编号,选取腰椎第1、3、5节为实验椎体。术后12周将羊处死,对各椎板缺损区进行MR扫描,计算瘢痕面积,并肉眼及放大镜观察瘢痕量及其与硬膜囊粘连情况。结果:隔囊组硬膜外瘢痕组织较疏松,瘢痕范围较小且量少,瘢痕与硬膜囊易于分离。隔膜组的硬膜外瘢痕组织多为疏松状,但瘢痕量较多,且范围较大,瘢痕与硬膜囊可行钝性分离。对照组的硬膜外瘢痕较致密,瘢痕范围较广泛,瘢痕量最多,瘢痕组织与硬膜囊粘连明显,分离困难,部分出现硬膜撕裂。结论:可吸收隔囊依赖其三维立体的空间效应及其内容物玻璃酸钠可以有效地预防硬膜外瘢痕的形成。Objectice： To investigate the earlier effects of absorbable spacing bag in prevention of epidural adhesions after laminectomy surgery. Methods： Eleven corriedale sheep were involved. According different methods of epidural local processing after laminectomy, the sheep were randomly divided into 3 groups：absorbable spacing bag group,polycaprolactone/polylactic acid film group, and control group（ saline application only）. The 11 sheep will be numbered, select the lumbar vertebrae 1,3,5 as experimental section. The sheep were killed and MR scan was performed 12 weeks later to measure the scar tissue areas and observe the amount of scarring and adhesion situation with dural by naked eye and a magnifying glass. Results：The epidural scar tissues were more loose, the scar areas and scar amount were small in absorbable spacing bag group. It was easy to separate between the epidural scar and dura mate. The scar tissues were loose, the scar areas and scar amount were more in polycaprolactone/ polylactic acid film group. It was little hard to separate between the epidural scar and dura mate. The scar tissues were dense and the scar areas were larger in control group. It was hard to separate between the epidural scar and dura mate. There were dura tears in several cases. Conclusion： Absorbable spacing bag can reduce epidural scar tissue effectively due to three-dimensional structure and its content of sodium hyaluronate.

关 键 词：椎板切除术 硬膜 粘连 可吸收隔囊 

分 类 号：R681.53[医药卫生—骨科学]