摘要
目的:研究应用自体大腿游离阔筋膜预防腰椎术后硬膜外粘连的效果。方法:2016年1月-2020年1月将36只新西兰大白兔随机分成对照组和实验组,每组18只。对照组单纯行全椎板切除,实验组行椎板切除+游离左侧的大腿阔筋膜覆盖椎板切除减压区。术后第2、4、8周每组各6只经麻醉处死。肉眼观察两组L6节段的椎板大体标本减压区的硬膜外瘢痕粘连的程度,并进行光镜下组织学观察。结果:大体观察结果显示,实验组术后第2、8周的硬膜外瘢痕粘连程度均较对照组轻(P<0.05);术后第4周,两组硬膜外粘连程度比较,差异无统计学意义(P>0.05);两组术后第2、4、8周硬膜外瘢痕粘连程度组内比较,差异均有统计学意义(P<0.05)。组织学观察结果显示,术后第8周,实验组硬膜外瘢痕粘连程度较对照组轻(P<0.05);术后第2、4周,两组的硬膜外瘢痕粘连程度比较,差异均无统计学意义(P>0.05);两组术后第2、4、8周硬膜外瘢痕粘连程度组内比较,差异均有统计学意义(P<0.05)。光镜下观察结果显示,实验组术后第2、4、8周的成纤维细胞计数均少于对照组,差异均有统计学意义(P<0.05);对照组术后第2、4、8周成纤维细胞计数比较,差异有统计学意义(P<0.05);实验组术后第2、4、8周成纤维细胞计数比较,差异无统计学意义(P>0.05)。结论:自体游离阔筋膜移植能够有效地减少椎板减压术后的硬膜外瘢痕粘连,值得今后在临床上进一步研究。
Objective:To investigate the preventive effect of graft of free autologous fascia lata on the epidural scar adhesion postlaminectomy.Method:From January 2016 to January 2020,36 New Zealand white rabbits were randomly divided into control group and experimental group,18 rabbits in each group.The control group was treated with total laminectomy,while the experimental group was treated with laminectomy and free left thigh fascia lata covering laminectomy decompression area.At 2,4 and 8 weeks postoperatively,6 rabbits in each group were killed by anesthesia.The degree of extradural scar adhesion in the decompression area of the gross lamina specimens of the L6 segment of the two groups was observed by gross eyes,and histological observation was made under light microscope.Result:The gross observation results showed that the degree of epidural scar adhesion in the experimental group were less than those in the control group at the 2nd and 8th weeks after surgery(P<0.05).At the fourth week after the surgery,comparison of the degree of epidural adhesion between the two groups,the difference was not statistically significant(P>0.05).Intra-group comparison of the degree of epidural scar adhesion between the two groups at 2,4 and 8 weeks after surgery,the differences were statistically significant(P<0.05).Histological observation showed that the degree of epidural scar adhesion in the experimental group was less than that in the control group at the 8th week after surgery(P<0.05).2,4 weeks after surgery,comparison of the degree of epidural scar adhesion between the two groups,the differences were not statistically significant(P>0.05).Intragroup comparison of the degree of epidural scar adhesion between the two groups at 2,4 and 8 weeks after surgery,the differences were statistically significant(P<0.05).The results under light microscope showed that the number of fibroblasts in the experimental group were less than those in the control group at 2,4 and 8 weeks after surgery,the differences were statistically significant(P<0.05).Comparison of the number of fibroblasts in the control group at 2,4 and 8 weeks after surgery,the difference was statistically significant(P<0.05).Comparison of the number of fibroblasts in the experimental group at 2,4 and 8 weeks after surgery,the difference was not statistically significant(P>0.05).Conclusion:Autologous free fascia lata transplantation can effectively reduce epidural scar adhesion after laminectomy,which is worthy of further clinical study in the future.
作者
苏瑞龙
林晓聪
蔡冬鹭
谢俊杰
颜丽笙
戴章生
何立江
吴俊哲
吴文华
SU Ruilong;LIN Xiaocong;CAI Donglu;XIE Junjie;YAN Lisheng;DAI Zhangsheng;HE Lijiang;WU Junzhe;WU Wenhua(The 2nd Hospital Affiliated to Fujian Medical University,Quanzhou 362000,China;不详)
出处
《中国医学创新》
CAS
2021年第20期22-28,共7页
Medical Innovation of China
基金
福建省自然科学基金项目(2019J01470)
福建省医学创新课题(2019-CX-30)
泉州市高层次人才创新创业项目(2017Z007)
泉州市科技创新领军人才项目(泉科[2014]61号文)
福建医科大学教授基金(JS11001)。
