聚乳酸防黏连膜预防椎板切除术后硬膜外黏连作用的临床应用研究

目的观察聚乳酸防黏连膜(PLAM)对椎板切除术后预防硬膜外黏连的临床效果.方法依照性别、年龄段、病种,将110例腰椎间盘突出症和腰椎管狭窄症患者,随机分为应用PLAM组(实验组)50例和不用PLAM的对照组60例.PLAM组在椎板缺损处缝入聚乳酸防黏连膜 (厚度为0.2 mm),对照组未置入聚乳酸防黏连膜.术后2周及4个月行手术节段MRI或增强CT扫描复查,观察术后硬膜外瘢痕的变化及并发症的改善情况,同时分别计数应用PLAM组和对照组出现腰腿痛等并发症的患者例数.结果应用PLAM组优良率96%,对照组优良率80%,两组有显著差异性(P＜0.05＝.复查CT应用PLAM组无硬膜外瘢痕黏连,对照组均有不同程度的硬膜外瘢痕黏连.结论聚乳酸防黏连膜具有较好的组织相容性,无毒副作用,能有效的预防硬膜外黏连,具有很好的临床应用价值.

Clinical application of poly lactic acid membrane in the prevention of epidural adhesion after lumbar laminectomy

Objective To investigate the clinical efficacy of poly lactic acid membrane(PLAM) in the prevention of epidural adhesion after lumbar laminectomy.Methods One hundred and ten patients with lumbar disc herniation and lumbar spinal canal stenosis were randomized to either PLAM group(50 patients) or to control group(60 50 patients),according to sex,age and disease type.the PLAM(0.2mm in sickness) was put into the damaged seam of the PLAM group patients,but not in control group.Two weeks and 4 months after operation,MRI or enhancement CT scanning examination was taken on operation segments to observe the changes in epidural scar and the improvement in the complications after the surgery.The incidence of complications was compared between two groups.Results The operation satisfactory rate of PLAM group was significantly higher than that of control group(96% and 80%,respectively,P<0.05).CT showed that there was no epidural scar adhesion in PLAM group patients,but varying degree of epidural scar adhesion existed in control group.Conclusion PLAM has good tissue compatibility,no toxic side effect.It can prevent epidural adhesion effectively and will be of great value to clinical practice.