几丁糖电纺膜预防脑脊液漏远期效果的实验研究

发布时间：2018-07-28 19:51

【摘要】：目的探讨几丁糖电纺膜预防脑脊液漏的远期效果。方法取健康成年新西兰家兔25只,雌雄不限,体重2.3~3.1 kg,于双侧颅骨顶部制备0.8 cm×0.8 cm大小对称硬膜缺损。右侧硬膜缺损采用几丁糖电纺膜修复(实验组),左侧缺损不修复,作为对照组。术后2~16周每周处死1只动物,观察骨窗周围局部炎性反应和几丁糖电纺膜吸收情况。术后3、6周,分别随机处死5只实验动物取材,行HE及Masson染色观察骨窗及几丁糖电纺膜周围组织病理学改变以及胶原化情况,行免疫组织化学染色观察EGF受体(EGF receptor,EGFR)和bFGF表达情况。结果术后两组均无皮肤及皮下红肿、渗出、化脓等炎性反应。实验组几丁糖电纺膜周围无粘连,膜下有新生纤维膜形成,无脑脊液漏,随时间延长几丁糖电纺膜逐渐降解,至16周时完全吸收;对照组骨窗周围组织为厚薄不均的增生瘢痕。组织学观察示,与对照组比较,实验组炎性细胞浸润较少,毛细血管、肉芽组织及胶原纤维大量增生,胶原纤维排列整齐,几丁糖电纺膜与周围胶原纤维有较清晰界限;3、6周时两组炎性细胞计数差异均有统计学意义(P0.05);免疫组织化学染色示,术后3、6周实验组见EGFR及bFGF高表达,对照组均为低表达。结论采用几丁糖电纺膜修复兔硬膜缺损,能有效重建硬膜,预防脑脊液漏远期效果明确。
[Abstract]:Objective to investigate the long-term effect of chitosan electrospinning film on prevention of cerebrospinal fluid leakage. Methods Twenty-five healthy adult New Zealand rabbits, male and female, weighing 2.3 ~ 3.1 kg, were used to prepare 0.8 cm 脳 0.8 cm symmetrical dura mater defect at the top of bilateral skull. The right dural defect was repaired with chitosan electrospun film (experimental group), while the left side defect was not repaired as control group. One animal was killed every week for observing the local inflammatory reaction around the bone window and the absorption of chitosan electrospun film. At 3 and 6 weeks after operation, 5 experimental animals were randomly sacrificed to observe the histopathological changes and collagenization around bone window and chitosan electrospinning membrane by HE and Masson staining, and the expression of EGF receptor EGFR and bFGF by immunohistochemical staining. Results there were no inflammatory reactions such as skin and subcutaneous redness, exudation and purulent in both groups. In the experimental group, there was no adhesion around the chitosan electrospinning film, no new fibrous membrane formed under the film, no cerebrospinal fluid leakage, and the chitin electrospun film was degraded gradually with time, and completely absorbed at 16 weeks, while the tissue around the bone window in the control group was a thin and uneven hypertrophic scar. Histological observation showed that, compared with the control group, the experimental group had less inflammatory cell infiltration, capillary, granulation tissue and collagen fiber proliferation, collagenous fibers arranged neatly, There were significant differences in the number of inflammatory cells between the two groups at the 6th week (P0.05), and the high expression of EGFR and bFGF was observed in the experimental group at 3 and 6 weeks after operation, and the low expression in the control group. Conclusion chitosan electrospun film can effectively reconstruct the dura mater and prevent cerebrospinal fluid leakage in rabbits.
【作者单位】：第二军医大学长征医院骨科;第二军医大学肾病研究所;
【分类号】：R318.08

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