几丁糖-钛网联合应用防治椎板切除术后瘢痕粘连的临床研究

目的通过观察板切除术后硬膜外瘢痕粘连的形态学改变及临床表现,分析几丁糖-钛网联合应用对防治硬膜外瘢痕粘连形成的作用极其效果。方法总结我院2005年3月-2006年12月对12例因椎管狭窄行全椎板减压、椎管扩大成型,并同时用几丁糖-钛网防治硬膜外瘢痕粘连的临床资料,分析评价其疗效及随访结果。结果12例患者术后经6～18个月随访,伤口愈合良好,无红肿、疼痛和感染,腰部无酸胀,活动不受限,亦无腰腿酸痛和麻木等症状发生。术后X线片和CT示钛网覆盖位置良好,椎管成型后的形态,并能有效的从三维立体角抑制椎板切除术后硬膜周围的瘢痕粘连。结论几丁糖加钛网能稳定椎管成型术后的形态,并能有效的从三维立体角度抑制椎板切除术后硬膜周围的瘢痕粘连。

The clinical application and curative effect of scar adhesion after laminectomy with chitosan-titanium mesh

Objective To observe the morphololgy changes and clinical manifestations of epidural scar adhesion after laminectom,and to analyze the effect of to prevent and cure epidural scar adhesive.Methods To summarize from Mar,2005 to Dec,2006 clinical data of the prevention and cure of epidural scar adhesive using whole vertebral plate decompression,canalis vertebralis enlargement molding,and chitosan-titanium mesh to 12 patients of spinal stenosis,and appraise curative effects and follow-up results.Results The postoperative follow-up 6 to 18 months,no red swellings,pains and infection,no aching pain in the waist,no activity constraint,waist and leg aching pains and numbness.X-ray and CT show the place of titanium mesh was good,no collapsing after canal vertebralis molding,no obvious scar adhension in epidural.Conclusion Chitosan-titanium mesh can stable the form of canalis vertebralis molding,and can suppress the scar adhensive with 3D after laminectomy.