Objective To study the result and the mechanism of preventing postoperative adhesion after orbit trauma by chitosan membrane, and to observe the effects of chitosan membrane on optic nerve and visual function. Methods It was a self-control trail. Ten white rabbits ( twenty eyes) were adopted in this experiment. Right eye on each rabbit was used in chitosan membrane experiment group and the left eye in control group. Trauma was made between superior rectus muscle and corresponding periosteum. Chitosan membrane was implanted between trauma tissues in the experimental group. F-VEP was tested 1 day before the operation and 6 days after operation in each rabbits. Degree of adhesion was evaluated by naked eyes;inflammatory score was evaluated by pathological examination and TGF-β impression was evaluated by immunohistochemical studies. Results F-VEP examination 6 days after the operation showed that the wave amplitude of P1 was (9.847 ± 2.320) mV, latency of P1 was (71.700 ± 5.144) ms. There was no difference between pre- and post-operative data (t =0.974, 0.228; P >0.01 ). Adhesion degree evaluation showed that there were 7 eyes with 1 score, 3 eyes with 2 score in the experimental group; while there were 1 eye with 2 score, 5 eyes with 3 score, 4 eyes with 4 score in the control group. There was a statistically significant difference (T = 59.00, P < O.01 ) in a1hesion degree between experimental group and control group. A statistically significant difference was presented in pathologic sheet score between the experimental and control groups. There were 6 eyes with 1 score, 4 eyes with 2 score in experimental group; while 2 eyes with 1 score, 4 eyes with 2 score, 4 eyes with 3 score in the control group. Immunohistochemical study showed strong positive in all slides of the experimental group, while only weakly positive in the control group. Conclusion Chitosan membrane is effective on decreasing the synthesis of collagen fibrils and preventing adhesion after the orbit trauma in the rabbits.%目的 探讨壳聚糖膜在眼眶损伤的早期修复中对软组织粘连的预防作用及其对视神经组织病理学结构和视功能的影响.方法 采用自身对照方法.取成年家兔10只,右眼为实验组,左眼为对照组.在上直肌与对应眼眶骨膜间人为制造创伤,实验组在创面问植入医用壳聚糖膜,对照组不做任何处理.每只兔眼术前和术后第6天行闪光视觉诱发电位(F-VEP)检查,并分别观察两组兔眼眼眶组织的粘连程度、炎性反应程度、转化生长因子(TGF)-β免疫组织化学染色情况.采用秩和检验和t检验进行统计学分析.结果 F-VEP检查术后P1波平均振幅为(9.847±2.320)mV,平均潜伏期为(71.700±5.144)ms,与术前比较,两者差异均无统计学意义(t=0.974,0.228;P＞0.01).粘连程度评分结果为对照组2分1只眼,3分5只眼,4分4只眼;实验组1分7只眼,2分3只眼,两组比较差异有统计学意义(T=59.00,P＜0.01).炎性反应程度评分结果为对照组1分2只眼,2分4只眼,3分4只眼;实验组1分6只眼,2分4只眼,两组比较差异有统计学意义(T=59.00,P＜0.01).TGF-β免疫组织化学染色结果显示对照组染色呈强阳性,实验组染色呈弱阳性.结论 医用壳聚糖膜可减少胶原纤维合成,在眼眶软组织损伤的早期修复中具有抑制粘连的作用.
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