摘要
目的通过对新西兰大白兔和本地犬的开颅手术,对比观察应用新型生物型人工硬脑膜及自体骨膜来替代原生硬脑膜的转归。方法全部动物共分为6组,兔9只,分1、6、12个月三组(n=3)；犬12只,分12、24个月及更长时间三个组(n=4)。每只动物分别应用新型硬脑膜及自体颅骨膜替代原生硬脑膜,手术后主要观察不同植入物在各组动物体内的转归。结果因两种替代材料替代动物原生硬脑膜6个月或以内实验动物的解剖未达到完全愈合,故呈不典型性,无代表意义。12个月或以后的实验动物解剖显示,两种替代材料外表面与颅骨膜有少许粘连、易分离,与周边缝合的原生硬脑膜已完全愈合,不可分辨,不能分离。从两种替代材料内表面来看,新型人工硬脑膜生长更接近原生硬脑膜,与脑表面无粘连或偶有丝状粘连；而自体骨膜与脑表面有丝状粘连并有少许柱状粘连。组织学镜下显示,植入物与宿主之间无嗜中性粒细胞、淋巴细胞等炎症细胞反应,无囊壁形成。新型人工硬脑膜内表面可见上皮细胞覆盖,上皮下可见纤维组织增生,纤维母细胞增生,植入物被降解,总量明显减少,内部可见毛细血管。结论新型人工硬脑膜的特性使其能产生上皮,不易形成与脑组织的粘连,并逐渐被自体组织蚕食、降解和替代,达到具有实际意义的硬脑膜重建。新型人工硬脑膜在修补硬脑膜缺损的实际应用中比自体膜有更大优越性。
Objective To compare the evolution of a new artificial dura mater and autogenous periosteum after replacing respectively orthotopic dura mater by means of performing the skull surgical operations on New Zealand white rabbits and local dogs. Methods All animals were divided into 6 groups. Nine rabbits were divided into 3 groups with 1, 6 and 12 month observation respectively（n=3）; 12 local dogs were divided into 3 groups observed for 12, 24 months and longer time period respectively（n=4）. The dura mater of each animal was replaced by implanting a new artificial dura and autogenous periosteum. After the operation, the evolution process of the different grafts in each group was observed. Results The zootomy in 6 months or within of the two materials being used to replace the animal＇s orthotopic dura mater showed no typical significance due to the incomplete cure. The zootomy in 12 months or later showed a little bit easily detachable adhesion of the outside surface of the two replacement materials to the skull perio steum. The animal＇ s orthotopic dura mater sutured around cured completely, without visible interface between the implanted dura and the orthotopic duramater. The inner surface of the two replacement materials showed that the growth of the new biological artificial dura mater is much closer to the orthotopic dura mater, with no adhesion or occasional filamentous adhesion to the brain surface, while there was filamentous adhesion and a little pillar adhesion between the autogenous periosteum and the brain surface. Histological and microscopic observations showed that there were no inflammatory cellular factors such as neutrophil cells, lymphoid cells and so on, and there was no cyst wall at the interface. The inner surface of the new artificial dura mater was seen to be covered with epithelial cells. The proliferations of the fibrous tissues and fibroblast were seen under the epithelia. The implanted material was degraded with a distinct reduction in its total amount. Capillaries were seen inside the material. Conclusion The nature of the new artificial dura mater allowed epithelial cells to grow, avoided the adhesion to the brain tissues and would gradually be encroached, degraded and replaced by the recipient＇s autologous tissues so that the dura mater could be reconstructed in a practical sense. The study revealed that the new artificial dura mater had a much more practical advantage over the autogenous periosteum in the reparation of the injured dura mater.
出处
《中华神经医学杂志》
CAS
CSCD
2006年第6期589-593,共5页
Chinese Journal of Neuromedicine
基金
广东省科技厅科研基金(2004B33801007)
广州市科技局科研基金(2004Z2-E0181)
关键词
人工硬脑膜
自体膜
实验
外科手术
Artificial dura mater
Autogenous periosteum
Experimentation
Surgical operation
