几丁糖电纺膜预防脑脊液漏远期效果的实验研究  

EXPERIMENTAL STUDY ON LONG-TERM PREVENTION EFFECT OF CHITOSAN ELECTROSPUN MEMBRANE ON CEREBROSPINAL FLUID LEAKAGE

作　　者：郭兴锋[1] 侯春林[1] 窦源东[1] 林晔[2] 雷德桥 

机构地区：[1]第二军医大学长征医院骨科,上海200003 [2]第二军医大学肾病研究所

出　　处：《中国修复重建外科杂志》2014年第8期993-997,共5页Chinese Journal of Reparative and Reconstructive Surgery

摘　　要：目的探讨几丁糖电纺膜预防脑脊液漏的远期效果。 方法取健康成年新西兰家兔25只，雌雄不限，体重2.3～3.1 kg，于双侧颅骨顶部制备0.8 cm × 0.8 cm大小对称硬膜缺损。右侧硬膜缺损采用几丁糖电纺膜修复（实验组），左侧缺损不修复，作为对照组。术后2～16周每周处死1只动物，观察骨窗周围局部炎性反应和几丁糖电纺膜吸收情况。术后3、6 周，分别随机处死5只实验动物取材，行HE及Masson染色观察骨窗及几丁糖电纺膜周围组织病理学改变以及胶原化情况，行免疫组织化学染色观察EGF受体（EGF receptor，EGFR）和bFGF表达情况。 结果术后两组均无皮肤及皮下红肿、渗出、化脓等炎性反应。实验组几丁糖电纺膜周围无粘连，膜下有新生纤维膜形成，无脑脊液漏，随时间延长几丁糖电纺膜逐渐降解，至16周时完全吸收；对照组骨窗周围组织为厚薄不均的增生瘢痕。组织学观察示，与对照组比较，实验组炎性细胞浸润较少，毛细血管、肉芽组织及胶原纤维大量增生，胶原纤维排列整齐，几丁糖电纺膜与周围胶原纤维有较清晰界限；3、 6周时两组炎性细胞计数差异均有统计学意义（P 〈 0.05）；免疫组织化学染色示，术后3、6周实验组见EGFR及bFGF 高表达，对照组均为低表达。 结论采用几丁糖电纺膜修复兔硬膜缺损，能有效重建硬膜，预防脑脊液漏远期效果 明确。Objective To study the long-term prevention effect of self-developed chitosan electrospun membrane on cerebrospinal fluid leakage.Methods Twenty-five healthy adult New Zealand rabbits were selected to prepare the bilateral dural defect （0.8 cm × 0.8 cm in size） via midline incision of head. Defect of the right was repaired with chitosan electrospun membrane as the experimental group; defect of the left was not repaired as the control group. At 2-16 weeks after operation, one rabbit was sacrificed for the general observation of inflammatory response surrounding bone window and absorption of chitosan electrospun membrane; at 3 and 6 weeks after operation, 5 rabbits were sacrificed for sampling to observe histological change and collagen expression by HE and Masson staining, and to measure the expressions of epidermal growth factor receptor （EGFR） and basic fibroblast growth factor （bFGF） by immunohistochemical staining.Results No inflammatory reaction of swelling, exudation, and sppuration appeared in the skin and subcutaneous tissue after operation in 2 groups. There was no adhesion around the chitosan electrospun membrane, and new fiber membrane formed under the chitosan electrospun membrane in the experimental group; no cerebrospinal fluid leakage happened; the chitosan electrospun membrane was gradually degraded with time, and was completely absorbed at 16 weeks. There was uneven scar around the dural detect in control group. Histological observation showed less inflammatory cell infiltration in the experimental group, showing significant difference in the number of inflammatory cells compared with control group at 3, 6 weeks （P 〈 0.05）; capillary, granulation tissue and collagen fiber massively proliferated; collagen fiber arranged in line, and there was a clear borderline between chitosan electrospun membrane and adjacent collagen fiber. The immunohistochemical staining showed that there were high expressions of bFGF and EGFR in the experimental group, and low expressions of bFGF and EGFR i

关 键 词：几丁糖电纺膜 脑脊液漏 硬膜缺损 远期效果 兔 

分 类 号：R318.08[医药卫生—生物医学工程]