球周注射壳聚糖甘油磷酸二钠对实验性白兔后巩膜的加固作用

发布时间：2018-01-17 17:04

本文关键词：球周注射壳聚糖甘油磷酸二钠对实验性白兔后巩膜的加固作用　出处：《陕西中医学院》2010年硕士论文　论文类型：学位论文

【摘要】： 目的:探讨球周注射壳聚糖甘油磷酸二钠对实验性白兔后巩膜的加固效果。方法: 1选用大耳白兔20只,雌雄各半,体重2-2.5kg,随机抽取5只为对照组。其余动物为处理组,均以左眼为手术眼。用注射器套自制的钝性针头,由切口处进针,沿筋膜下间隙紧贴着巩膜向后进针3mm-4mm,注入壳聚糖甘油磷酸二钠1.2ml-1.5ml。术毕用庆大地米注射液冲洗结膜囊,涂红霉素眼膏,包扎术眼。 2术后正常活动、定时饮食,测实验动物0h、24h、48h、72h餐前身体重量,计算每日重量改变量。 3术后2、4、8周测眼压、眼底荧光血管造影、眼眶CT、眼A超、眼B超。之后耳缘静脉注入空气处死白兔,冰冻兔头12小时后用自制小锯条沿兔眼眶做冠状切面和矢状切面,其余动物摘除眼球,冲洗干净,切取混合巩膜组织,先肉眼观察,再分别以10%福尔马林液固定,石蜡包埋切片,HE染色,光镜观察。结果: 1 C/GP生物相容性:球周注射C/GP引起眼部轻度炎症反应。 2眼压测量结果:术后2周、4周、8周,2周组与对照组左眼眼压比较没有统计差异(P0.05);2周组和4周组比较没有统计学差异(P0.05);4周、8周组较对照组左眼眼压升高,有统计学差异(P0.05);2周和8周组比较,8周组眼压升高,有统计学差异(P0.05);4周和8周组比较,8周组眼压升高,有统计学差异(P0.05);右眼各组间2、4、8周眼压比较没有统计学差异(P0.05)。 3眼轴测量结果:动物眼部球周注射C/GP对眼轴影响较对照组无统计学差异(P0.05);术后2、4、8周左眼眼轴比较无统计学差异(P0.05),右眼眼轴比较无统计学差异(P0.05),左眼和右眼眼轴比较无统计学差异(P0.05)。 4眼眶CT检查结果:2周组左眼后极部偏颞上方巩膜较对照组左眼显著增厚,形成一规则环状“新巩膜”,密度均匀,与巩膜密度大致相同,低于眶骨密度,其与周围眼眶间隙清晰,视神经清晰规整。 5 B超检查结果:术后2周B超见左眼后部颞上方后巩膜有不规则条状低回声区,术后4周后此低回声区变为月牙状强回声区,术后8周此强回声区减弱,后部巩膜回声均匀一致,玻璃体未见异常回声,视网膜回声规整,视神经回声规整,眶内未见异常回声。 6冰冻眼球切面结果:术后8周冰冻眼球切面见,龙胆紫染色组织均匀地贴附于后部巩膜上,并与巩膜融为一体,与周围组织间隙清楚。 7巩膜组织病理学观察结果:术后2周见,巩膜表层胶原纤维排列粗细不均,炎性细胞增加,新生血管增生。术后4周见巩膜表层肉芽组织增生,新生血管增生。术后8周见后巩膜胶原纤维增粗,排列整齐,肉芽组织增生,后巩膜增厚。 8眼底荧光血管造影观察结果:对照组与实验组眼底荧光造影未发现明显变化。结论: 1壳聚糖甘油磷酸二钠在眼部球周注射的炎性反应很小,生物相容性较好,可作为后巩膜加固术的一种新型材料。 2球周注射壳聚糖甘油磷酸二钠改变了巩膜的硬度及弹性,但对眼轴的影响不大。 3壳聚糖甘油磷酸二钠混合物球周注射后能够均匀的在球后巩膜分布,并与巩膜紧密的贴附,支撑着后巩膜。 4球周注射物对视网膜脉络膜及玻璃体无影响;壳聚糖甘油磷酸二钠与巩膜融合后发生炎症反应,新生血管增生,肉芽组织增生,胶原纤维增粗,排列整齐,巩膜重新塑形。
[Abstract]:Objective: To investigate the effect of two sodium chitosan glycate phosphate on the posterior sclera of experimental rabbits.
Method:
1 selected 20 rabbits, male and female, weight 2-2.5kg, 5 rats were randomly selected as control group. The animal is the treatment group in the left eye for eye surgery. Blunt needle made with a syringe sleeve, the incision into the needle, along the fascia gap close to the scleral backward 3mm-4mm needle, injecting shell the chitosan glycerol phosphate sodium two 1.2ml-1.5ml. after operation Yongqing meters earth irrigating conjunctival sac injection, with Erythromycin Eye Ointment, bandaging the eye.
2 normal activities after operation, regular diet, test the body weight of 0h, 24h, 48h, 72h before meal, and calculate the daily weight change.
2,4,8 intraocular pressure measurement after 3 weeks, fundus fluorescein angiography, orbital CT, A eye ultra, B-ultrasonography. After ear vein injection of air to kill rabbits, frozen rabbit after 12 hours with a homemade small blade along the rabbit orbital coronal and sagittal plane, the remaining animal removal of the eye, rinse, cut mixed scleral tissue first, the naked eye, then in 10% formalin fixed, paraffin section, HE staining, light microscopy.
Result:
1 C/GP biocompatibility: a mild inflammation of the eye caused by a weekly injection of C/GP.
2 intraocular pressure measurements: 2 weeks after surgery, 4 weeks, 8 weeks, 2 weeks group and the control group has no statistical difference in IOP between the left eye (P0.05); no statistical differences between the 2 week and 4 week group (P0.05); 4 weeks and 8 weeks group than in the control group increased intraocular pressure of the left eyes, there were significant differences (P0.05); 2 and 8 weeks group, 8 weeks group elevated intraocular pressure, there was significant difference (P0.05); 4 and 8 weeks group, 8 weeks group elevated intraocular pressure, there were significant differences between the groups (P0.05); the right eye 2,4,8 weeks intraocular pressure is not statistically significant (P0.05).
3 axis measurement results: animal eye peribulbar injection of C/GP on axial than in the control group had no significant difference (P0.05); 2,4,8 weeks after surgery the left eye axis had no significant difference (P0.05), right eye axis had no significant difference (P0.05), the left and right eye axis had no significant difference (P0.05).
4 orbital CT findings: the 2 week group had thickened sclera on the upper temporal part of the left eye. Compared with the control group, the left eye was thickened, forming a regular new sclera. The density was homogeneous, and the density of sclera was almost the same as that of the sclera, which was lower than that of the orbital bone. The density of the sclera was clear with the surrounding orbital clearance, and the optic nerve was clear and regular.
5 ultrasound examination results: 2 weeks after operation the left rear B see above the posterior temporal irregular strip low echo area, after 4 weeks after the low echo area into echodensities crescent, decreased 8 weeks after operation Ciqiang echo area, posterior sclera echo uniform, vitreous body retina no abnormal echo, echo regular, optic echo regular, no abnormal echo in the orbit.
Results: 6 frozen section of the eyeball eyeball section frozen after 8 weeks, crystal violet staining of tissue uniformly attached to the posterior sclera and the sclera, and blend with the surrounding tissue space clear.
The observation results of 7 scleral tissue pathology: 2 weeks after operation, the surface sclera collagen fibers were uneven thickness, increase in inflammatory cells and neovascularization. The surface sclera hyperplasia of granulation tissue at 4 weeks after operation, neovascularization. After 8 weeks after scleral collagen fiber thickening, arranged neatly in granulation tissue hyperplasia of posterior scleral thickening.
The results of 8 fundus fluorescein angiography showed that the contrast group and the experimental group had no obvious changes in fundus fluorescein angiography.
Conclusion:
The inflammatory response of 1 chitosan glyceryl phosphate two sodium in the eye sphere is very small and has good biocompatibility. It can be used as a new material for the reinforcement of the posterior sclera.
The hardness and elasticity of the sclera were changed by injection of chitosan glyceric phosphoric acid two in 2 weeks, but there was little effect on the eye axis.
The 3 chitosan glyceryl phosphate two sodium mixture can be evenly distributed in the posterior sclera after the ball injection and adhered closely with the sclera, supporting the posterior sclera.
4, there was no effect on the retina choroid and vitreous by injecting the ball around the ball. After the fusion of chitosan glycerol phosphate two sodium and sclera, inflammatory reaction, neovascularization, granulation tissue hyperplasia, collagen fiber thickening, orderly arrangement and sclera remodeling were achieved.

【学位授予单位】：陕西中医学院
【学位级别】：硕士
【学位授予年份】：2010
【分类号】：R779.6

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