CAJ | 학술논문

背景:羊膜在眼科领域的应用比较普遍,许多研究表明羊膜移植并不引起急性免疫排斥反应,这提示其可以作为修补硬脑膜缺损的安全材料.目的;探讨羊膜作为硬脑膜修补材料的可能性.方法:将豚鼠颅顶部冠状缝后、矢状缝两侧开骨窗.在右侧骨窗下切除硬脑膜,缺损处用冻干羊膜修补.左侧骨窗下切除硬脑膜后再将切下的硬脑膜修补复位,做为对照.分别在术后第15,30,60,90天处死,取修补部位脑膜标本,苏木精-伊红染色,进行组织学观察.结果与结论:术后所有动物行为无异常,皮肤切口如期愈合,无感染、无皮下积液、无脑脊液漏.植入物逐渐被降解并被一层结缔组织覆盖,修补部位与大脑表面无粘连.术后15 d较多散在的成纤维细胞出现在修补材料内.术后30 d部分修补材料消失,修补材料中心部位纤维结缔组织增生,未见炎细胞浸润.术后60 d修补材料大部分消失,被增生及轻度变性的纤维结缔组织替代,周围见少量的异物巨细胞.术后90 d修补材料呈胶原变性,其周围见骨化组织及变性的纤维结缔组织,未见炎细胞浸润.动物实验证明冻干羊膜是一种安全、有效的硬脑膜修补材料.
배경:양막재안과영역적응용비교보편,허다연구표명양막이식병불인기급성면역배척반응,저제시기가이작위수보경뇌막결손적안전재료.목적;탐토양막작위경뇌막수보재료적가능성.방법:장돈서로정부관상봉후、시상봉량측개골창.재우측골창하절제경뇌막,결손처용동간양막수보.좌측골창하절제경뇌막후재장절하적경뇌막수보복위,주위대조.분별재술후제15,30,60,90천처사,취수보부위뇌막표본,소목정-이홍염색,진행조직학관찰.결과여결론:술후소유동물행위무이상,피부절구여기유합,무감염、무피하적액、무뇌척액루.식입물축점피강해병피일층결체조직복개,수보부위여대뇌표면무점련.술후15 d교다산재적성섬유세포출현재수보재료내.술후30 d부분수보재료소실,수보재료중심부위섬유결체조직증생,미견염세포침윤.술후60 d수보재료대부분소실,피증생급경도변성적섬유결체조직체대,주위견소량적이물거세포.술후90 d수보재료정효원변성,기주위견골화조직급변성적섬유결체조직,미견염세포침윤.동물실험증명동간양막시일충안전、유효적경뇌막수보재료.
BACKGROUND: Amnion has been widely used in ophthalmology. Numerous studies have suggested that amnion transplantation did not induce acute immunologic rejection. These indicated that amnion transplantation can be used as a safe material for repair of dural defects.OBJECTIVE: To study the probability of freeze-dried amniotic membrane (FDAM) as a dural substitue. METHODS: Each of the guinea pigs underwent bilateral parietal craniectomy behind the coronal suture and beside the midline to expose the dura. On the right side, a piece of dura mater was removed. The dural defect was covered with a piece of FDAM. The exposed dura on the left was cut and sutured itself as control. The animals in each group were sacrificed at 15, 30, 60 and 90 days after operation, respectively. The implants were harvested and stained with hematoxylin-eosin, and histologically analyzed. RESULTS AND CONCLUSION: After operation, the behavior of all guinea pigs remained completely normal. The wound healing was achieved in all cases. No wound infection, subcutaneous effusion or cerebrospinal fluid (CSF) leakage occurred. The graft was degraded gradually and covered with a sheet of connective tissue. Dural defects repaired with FDAM showed no adhesions to the brain surface. 15 days after operation, plenty of scattered fibroblasts appeared in the dural substitute. 30 days alter dural graft implantation, parts of the implant disappeared; meanwhile the hyperplasia of fibrous connective tissue took place in the center part of the dural substitute, without the infiltration of inflammatory cells. 60 days after implantation, a majority of the dural graft was degraded, substituted by fibrous connective tissue which was of hyperplasia and low-grade degeneration, surrounded by a small quantity of giant cells. 90 days after operation, colloidal degeneration happened in the dural substitute, surrounded by ossification tissue and the degenerated fibrous connective tissue. The inflammatory cells were not discovered. The animal experiment proves FDAM to be a safe and applicable dural substitute.