医用组织黏合剂黏合兔眼巩膜穿通伤口及传统缝合对比实验探究.docVIP

医用组织黏合剂黏合兔眼巩膜穿通伤口及传统缝合对比实验探究 　 作者：王蕊，吴楠，吴燕，翁传煌，曾玉晓，霍姝佳，王一 【摘要】 目的 探讨a氰基丙烯酸正辛酯为主体的医用化学组织黏合剂密闭兔眼巩膜全层裂伤的可能性。方法 45只成年兔建立经巩膜穿通伤模型,右眼用医用胶黏合，左眼缝线缝合,术后3、7、14、30、90天观察医用胶的降解，对比观察伤口组织病理学愈合情况。结果 医用胶能够迅速密闭巩膜伤口。术后各观察时间点,眼前、后节均未观察到炎症反应。电镜和光镜观察组织伤口均愈合。随巩膜伤口愈合,抗球内压力逐渐增加。医用化学组织黏合剂术后3个月分解吸收。结论 医用化学组织黏合剂可有效密闭巩膜穿通伤。 【关键词】 巩膜;穿透伤;组织黏合剂;a氰基丙烯酸正辛酯;缝合;兔 Abstract: Objective To investigate the feasibility of adhesion of chemical tissue adhesive(2Octyl Cyanoacrylate) for sclerotic penetrating wound.Methods Fortyfive Japan rabbits were randomly divided into five groups,each group had nine rabbits.Right eyes were cyanoacrylate adhesive group,left eyes were suture group.On days 3，7，14，30 and 90 after surgery,the conditions of conjunctiva and anterior chamber were observed by Slitlamp biomicroscopy after surgery;the condition of sclerotic wound healing and cyanoacrylate adhesive degradation were observed;the tensile strength of eyeball was measured;the tissue of corneal wounds were observed by light microscope and transmission electron microscope examination.Results The medical adhesive quickly occluded the sclerotic penetrating wounds during operation.After surgery inflammation was not found in the eyes in the adhesive groups.Light microscope observations showed the wounds cicatrized.The tensile strengths of sclerotic wounds were increasing with time.Finally,the medical adhesive was degraded and absorbed.Transmission electron microscope observations showed that shape and structure of sclera collagen fiber and fibroblasts were similar in both groups.Conclusion The initial study demonstrates the adhesion for sclerotic penetrating wound with CA is available. 　　Key words:sclerotic;penetrating wound;tissue adhesion;cyanoacrylate;suturing;rabbits 　　眼球穿通伤是常见眼外伤，目前临床治疗方法主要是显微镜下缝线缝合。近几年，医用化学组织黏合剂因其使用便捷、安全、价廉，已被用于眼科手术治疗，但是用于治疗巩膜穿通伤的研究尚未见报道。本研究用a氰基丙烯酸正辛酯与正丁酯混合医用黏合剂黏合巩膜穿通伤口，并与医用线缝缝合方法比较，以评价化学医用黏合剂密闭巩膜穿通伤口的可行性。材料与方法 　　1 实验动物及材料 　　6月龄普通级日本大耳白兔45只，体重2.0~2.8kg(平均2.43kg)，雌雄不拘(第三军医大学实验动物中心提供)，眼部经检查无病变。医用胶由