聚乙丙交酯膜联合生物蛋白胶预防硬膜外粘连的实验研究

摘要

Objective To approach the prophylactic function of newly production,absorbable PLGA membrane and absorb-able bioprotein glue in prevention of epidural and nerve root adhesions after laminectomy.Mtehods We excised the L6 ver-tebral plates of 36 adult New Zealand male rabbits,to make vertebral plate excision model.Probe the nerve root.Then di-vided them into 5 groups according to different materials:PLGA membrane group,bioproten glue group,PLGA membrane and bioprotien glue group,gelatin sponge group and saline solution group .We observed clinic events of the rabbits every-day.The morphological changes of the scars were observed grossly and histologically on 2 and 8 weeks after operation,and we also measured the orbit of the nerve root.Results We observed adhesion degree grossly and epidural adhesion classifica-tion under light microscope,and found that compared to other groups,PLGA membrane combining with bioprotein glue group was statistically different ( P<0.05 ) .The range of nerve root activity and cell count of fibroblasts of each group at the same time,PLGA membrane combining with bioprotein glue group was statistically different compared with other groups (P<0.05).PLGA membrane combining with bioprotein glue group has no statistical difference on 2 and 8 weeks after sur-gery (P>0.05).while the other four groups were statistically different on 2 and 8 weeks after surgery (P<0.05).Con-clusion PLGA membrane combining with bioprotein glue can lessen spinal dural mater and nerve root adhesions with sur-rounding tissue,without affecting healing of cutting edge.We may make great use of it in clinic in the future.%目的：观察聚乙丙交酯（ PLGA）薄膜和生物蛋白胶联合应用预防椎板切除术后硬膜外及神经根粘连的作用。方法60只成年新西兰雄兔切除L 6椎板，制作动物模型，并探查神经根，根据应用材料不同分为5组： PLGA膜组、生物蛋白胶组、PLGA膜和生物蛋白胶组、明胶海绵组、对照组（0．9％生理盐水），每组12只。术后观察动物的一般情况，第2、8周每组各处死6只，取标本行大体形态观察、神经根活动范围测量及组织学观察。结果大体观察粘连程度及光镜下硬膜外粘连分级，PLGA膜和生物蛋白胶组与其他各组比较差异均有显著性意义，P＜0．05。神经根活动范围及光镜下成纤维细胞计数每组在同一时间比较，PLGA膜和生物蛋白胶组与其他组比较差异均有显著性意义，P＜0．05；术后2周和8周比较，PLGA膜和生物蛋白胶组差异无显著性意义，P＞0．05；其他4组术后2周和8周比较差异均有显著性意义，P ＜0．05。结论 PLGA膜联合生物蛋白胶能有效地减轻硬脊膜及神经根与周围组织的粘连，而不影响切口愈合。