壳多糖膜预防椎板切除术后硬膜周围粘连的实验研究

目的　观察壳多糖膜预防椎板切除术后硬膜周围粘连的作用。方法　２４ 只成年新西兰白兔 Ｌ３ 、 Ｌ５ 水平切除椎板１ ．０ ｃｍ ×０ ．５ ｃｍ ， Ｌ３ 硬膜外放置壳多糖膜（ Ａ 点） ， Ｌ５ 作为空白对照（ Ｂ 点） 。分别于术后３ 、６ 、１２ 周进行大体形态、光镜观察。结果　 Ａ 点硬膜外粘连程度明显低于 Ｂ 点；光镜观察 Ａ 点粘连范围明显低于 Ｂ 点， Ａ 点硬膜外有空隙，未见明显异物、炎症反应， Ｂ 点硬膜外与瘢痕紧密粘连，瘢痕侵入椎管内，对硬膜有压迫。结论　壳多糖膜具有明显的预防硬膜周围粘连的作用。

An experimental study on prevention of postlaminectomy adhesion by the use of chitosan membrane

Objective To study the effect of chitosan membrane in the prevention of extradural adhesion after laminectomy. Methods Laminectomies were performed at lumbar vertebrae L 3 and L 5 in 24 adult rabbits. Two laminectomy sites provided auto controls in each animal. A piece of chitosan membrane was placed into L 3, and L 5 served as control. The animal killed 3,6,12 weeks after surgery were observed grossly and histologically. Results Adhesion of the dura to the sear tissue occurred to the entire exposed surface at the control levels, but no adhesion of dura was found and the extradural space well maintained in the levels of chitosan membrane treated. Conclusion Chitosan membrane might be useful for the prevention of scar extension into the spinal canal and preventing the dura from adhesion of scar tissue after laminectomy.