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.pdfVIP

中国康复理论与实践2015年1月第21卷第1期 ChinJRehabilTheoryPract,Jan., 2015,Vol.21,No.1 - 45 - DOI: 10.3969/j.issn. 1006-9771.2015.01.012 ·基础研究 · 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① 1 1 1 1 2 2 2 1 苏迪娅 ，刘松 ，王世炜 ，历俊华 ，崇逢 ，李东风 ，李睿智 ，万虹 [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、B 1) 、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：A 1组 Ⅰ级、A2 组Ⅱ级、A3 组Ⅲ级，B 1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(P0.05) 。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 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. Beijing Neurosurgical Institute, Beijing Tiantan Hospital of Capital Medical University, Beijing 100050, China 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/B 1), 2 (groups A2/B2) and 4 (groups A3/B3) weeks after operation, while the spi- nal nerves were observed with HE staining and Masson staining, and the adhesion was assessed with