明胶-壳多糖交联膜预防硬脑膜粘连的初步研究

目的:研究自制明胶壳多糖交联膜的止血和防硬脑膜粘连功能。方法:壳多糖与明胶混合液交联后置入冻干机冻干制得明胶-壳多糖交联膜,新西兰家兔脊柱两侧各剪渗血创面,分别敷以明胶-壳多糖交联膜和灭菌纱布止血,记录出血时间,以膜或纱布中Hb 560 nm光密度值(D560)表示出血量;新西兰家兔双侧颅顶部开窗,剪除兔的硬脑膜,置入明胶-壳多糖交联膜,对侧空白对照。术后2、4、8、12周观察粘连情况。结果:使用明胶-壳多糖交联膜出血时间为(78±6)s,Hb的.D560为0.76±0.51,与对照组的(119±11)s和1.63±0.72相比有显著差异(P<0.01)。明胶一壳多糖交联膜组瘢痕与硬脑膜下组织无明显粘连,硬脑膜下间隙存在,未见明显炎症反应;对照组粘连明显,对脑组织有牵拉。结论:明胶一壳多糖交联膜具有明显的止血及防硬脑膜粘连功能。

Gelatin-chitosan crosslinked film in prevention of adhesion after Craniotomy

Objective:To study the hemostatic and adhesion-prevention properties of gelatin-chitosan crosslinked film after craniotomy. Methods: Gelatin-chitosan crosslinked film was prepared by casting the mixed solution of dialyzed chitosan and gelatin after crosslinking with glutaraldehyde in freeze dryer. Bleeding time was recorded for bilateral back incisions (5 incisions on each side) in 4 New Zealand white rabbits. Incision on one side was treated with gelatin-chitosan crosslinked film, and on the other was treated with gauze. Hemoglobin amount in films or gauzes was measured to determine the hemostatic effect after bleeding. Bilateral craniotomies were performed at calvaria in 16 adult rabbits. A piece of gelatin-chitosan crosslinked film was put in one randomized side and the other side served as a control. The scar formation was evaluated grossly and histologically on week 2,4,8,12. Results:Bleeding time and hemoglobin amounts in gelatin-chitosan crosslinked film group were superior to those in gauze group(P<0. 01). In the treated side, no adhesion was observed and the space between scar tissue and pia mater or encephalon was well preserved. In the control side, adhesion to the scar tissue occurred in the entire exposed surface. The difference of the 2 sides was significant(P<0. 05). Conclusion:Gelatin-chitosan crosslinked film promises to be effective in hemostasis and preventing adhesion of scar tissue.