《中国康复理论与实践》

《中国康复理论与实践》 ›› 2015, Vol. 21 ›› Issue (01): 45-048.

• 基础研究 • 上一篇    下一篇

椎板切除神经根损伤后聚羧甲基葡萄糖胺产品抗瘢痕粘连的效果

苏迪娅1，刘松1，王世炜1，历俊华1，崇逢2，李东风2，李睿智2，万虹1
   

  1. 1.首都医科大学北京市神经外科研究所损伤修复室，北京市100050；2.北京爱美客生物科技有限公司，北京市100022。
  • 收稿日期:1900-01-01 修回日期:1900-01-01 出版日期:2015-01-25 发布日期:2015-01-25

Effect of A Chitosan Product on Scarring and Adhesion of Injured Nerve after Laminectomy

SU Di-ya, LIU Song, WANG Shi-wei, LI Jun-hua, CHONG Feng, LI Dong-feng, LI Rui-zhi, WAN Hong.
  

  1. Beijing Neurosurgical Institute, Beijing Tiantan Hospital of Capital Medical University, Beijing 100050, China
  • Received:1900-01-01 Revised:1900-01-01 Published:2015-01-25 Online:2015-01-25

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被引次数

1

摘要： 目的探索聚羧甲基葡萄糖胺产品防止神经损伤后瘢痕粘连形成的效果。方法48 只雄性Sprague-Dawley 大鼠分为A、B 两组。大鼠切除L4-5椎板，暴露并损伤右侧神经根。A组术区涂抹生理盐水，B 组涂抹聚羧甲基葡萄糖胺产品。术后第1(A1、B1)、2 (A2、B2)、4 周(A3、B3)对各组神经根周围粘连行Rydell 评分；HE染色、Masson 染色观察，行粘连组织学Nussbaum评分；检测血常规和肝、肾功能。结果各组Rydell 评分：A1 组Ⅰ级、A2 组Ⅱ级、A3 组Ⅲ级，B1 组0 级、B2 组0 级、B3 组Ⅱ级。HE染色示B组较A组神经根周围粘连速度慢且瘢痕生长疏松。Masson染色示B组较A组神经根周围瘢痕组织网稀疏散在，且随时间延长其致密程度加深不明显。组织学Nussbaum 评分示，同时段A、B组间比较均有显著性差异(P<0.05)。各组大鼠血常规及肝、肾功能均在正常参考值范围内。结论聚羧甲基葡萄糖胺产品能有效防止椎板切除术后神经根周围及硬膜外瘢痕粘连形成，无毒副作用。

关键词: 聚羧甲基葡萄糖胺, 椎板切除术, 神经根, 瘢痕, 粘连, 大鼠

Abstract: Objective To investigate the effects of a chitosan product on scarring and adhesion after never injury in laminectomy in rats. Methods 48 male Sprague-Dawley rats were divided into group A and group B, and carried laminectomy of L4-5, and injured the right spinal nerve roots. The normal saline was smeared on the operation field in the group A, while the chitosan product was smeared in the group B. The adhesion was assessed with Rydell score 1 (groups A1/B1), 2 (groups A2/B2) and 4 (groups A3/B3) weeks after operation, while the spinal nerves were observed with HE staining and Masson staining, and the adhesion was assessed with Nussbaum score. The complete blood count and the series of blood chemistries and enzymes for liver and kidney functioning were measured. Results The Rydell scores of adhesion was I grade in group A1, II grade in A2 and III grade in A3, while was 0 grade in B1, 0 grade in B2 and II grade in B3. The scar and adhesion contact more loosely in the group B than in the group A, and the Nussbaum score was less in the group B than in the group A at the same time (P<0.05). The complete blood count and the series of blood chemistries and enzymes for liver and kidney functioning were in normal. Conclusion This chitosan product can prevent the formation of epidural scar and adhesion around the spinal and the nerve roots after laminectomy, with little toxicity and side effects.

Key words: chitosan, laminectomy, nerve roots, scar, adhesion, rats