中国组织工程研究

中国组织工程研究 ›› 2012, Vol. 16 ›› Issue (43): 8094-8099.doi: 10.3969/j.issn.2095-4344.2012.43.024

• 药物控释材料 drug delivery materials • 上一篇    下一篇

Micro-CT联合硬膜外造影在医用自交联透明质酸钠凝胶预防椎板切除后硬膜外粘连中的应用

梁文锴1，郭全义2，韩树峰1，张 莉2，彭 江2，汪爱媛2，睦 翔2，梁增义3，许文静2，卢世璧2   

  1. 1山西医科大学第一临床医学院，山西省太原市 030001
    2解放军总医院骨科研究所，北京市 100853
    3北京申佑生物科技有限公司，北京市 100853
  • 收稿日期:2012-02-08 修回日期:2012-03-18 出版日期:2012-10-21 发布日期:2012-10-21
  • 通讯作者: 郭全义，主任医师，解放军总医院骨科研究所，北京市 100853 doctorguo@ 163.com
  • 作者简介:梁文锴★，男，1984年生，山西省太原市人，汉族，山西医科大学在读硕士，主要从事脊柱外科研究。 ivwvi@163.com

Application of Micro-CT combined with epidurography in medical self-crosslinked sodium hyaluronate gel for the prevention of epidural adhesions after laminectomy

Liang Wen-kai1, Guo Quan-yi2, Han Shu-feng1, Zhang Li2, Peng Jiang2, Wang Ai-yuan2, Sui Xiang2, Liang Zeng-yi3, Xu Wen-jing2, Lu Shi-bi2   

  1. 1Department of Orthopedics, First Clinical Medical College, Shanxi Medical University, Taiyuan 030001, Shanxi Province, China
    2Institute of Orthopedics, General Hospital of Chinese PLA, Beijing 100853, China
    3Beijing ShenYou Biological Technology Co., Ltd., Beijing 100853, China
  • Received:2012-02-08 Revised:2012-03-18 Online:2012-10-21 Published:2012-10-21
  • Contact: Guo Quan-yi, Chief physician, Institute of Orthopedics, General Hospital of Chinese PLA, Beijing 100853, China doctorguo@163.com
  • About author:Liang Wen-kai★, Studying for master’s degree, Department of Orthopedics, First Clinical Medical College, Shanxi Medical University, Taiyuan 030001, Shanxi Province, China ivwvi@163.com

PDF

484

被引次数

6

摘要：

背景：二维平面角度已证实医用自交联透明质酸钠凝胶能够在术后8周有效预防兔椎板切除后硬膜外粘连的发生。
目的：应用Micro-CT联合硬膜外造影技术观察和评估自交联透明质酸钠凝胶预防椎板切除后硬膜外粘连的可行性。
方法：将18只L5椎板全切除的新西兰大白兔随机分组：对照组用生理盐水冲洗术区后关闭切口；HyaRegen/SPⅠ组用医用自交联透明质酸钠凝胶HyaRegen/SPⅠ 0.5 mL覆盖暴露硬脊膜后关闭切口；HyaRegen/SPⅡ组用医用自交联透明质酸钠凝胶HyaRegen/SPⅡ 0.5 mL覆盖暴露硬脊膜后关闭切口。
结果与结论：各组体感诱发电位潜伏期均无明显延长，3组间差异无显著性意义(P > 0.05)。Micro-CT联合硬膜外造影扫描并三维重建后显示，HyaRegen/SPⅠ组及HyaRegen/SPⅡ组对比剂能够顺利充盈硬膜外间隙，对照组对比剂充盈不顺畅，在术区局部形成多处充盈缺损。HyaRegen/SPⅠ组及HyaRegen/SPⅡ组术区硬脊膜外单位体积内对比剂充盈体积均高于对照组(P < 0.05)，前2组间差异无显著性意义(P > 0.05)。对照组硬膜外粘连程度要远高于HyaRegen/SPⅠ组及HyaRegen/SPⅡ组(P < 0.05)。证实医用自交联透明质酸钠凝胶可有效预防兔椎板切除后硬膜外粘连的发生，应用Micro-CT联合硬膜外造影技术能有效观察和评估硬膜外粘连。

关键词: Micro-CT, 硬膜外造影, 透明质酸钠凝胶, 硬膜外粘连, 对比剂, 生物材料

Abstract:

BACKGROUND: Medical self-crosslinked sodium hyaluronate gel can effectively prevent epidural adhesions after laminectomy in rabbits within 8 weeks after operation, which has been confirmed by planar angle.
OBJECTIVE: To observe and evaluate the practicability of self-crosslinked sodium hyaluronate gel in preventing epidural adhesions by using Micro-CT combined with epidurography.
METHODS: Eighteen new Zealand white rabbits with total lumbar laminectomy at L5 level were randomly divided into three groups: control, HyaRegen/SPⅠ and HyaRegen/SPⅡ groups. In the control group, only normal saline was used to flush the laminectomy area before wound closure, while in HyaRegen/SPI and HyaRegen/SPⅡ groups, the exposed dura mater was covered with 0.5 mL HyaRegen/SPI or 0.5 mL HyaRegen/SPII, respectively before wound closure.
RESULTS AND CONCLUSION: The latency of cortical somatosensory evoked potentials was not delayed obviously in each group, and there was no significant difference in the three groups (P > 0.05). The scanning of Micro-CT combined with epidurography and the images of three-dimensional reconstruction showed that contrast agent could fill the epidural space smoothly in the HyaRegen/SPⅠ and HyaRegen/SPⅡ groups, but not in the control group, and many filling defects in local operation area could been observed. In addition, the filling volume of contrast agent of the HyaRegen/SPⅠ and HyaRegen/SPⅡ groups in the unit volume of operation area was higher than that in the control group (P < 0.05). There was no significant difference between HyaRegen/SPI and HyaRegen/SPⅡ groups (P > 0.05). Moreover, the degree of epidural adhesions of the control group was significantly higher than that in the HyaRegen/SPI and HyaRegen/SPⅡ groups (P < 0.05). These findings suggest that medical self-crosslinked sodium hyaluronate gel can effectively prevent epidural adhesions after laminectomy in rabbits. Besides, epidural adhesions can be observed and evaluated effectively by using Micro-CT combined with epidurography.

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