中国组织工程研究与临床康复
中國組織工程研究與臨床康複
중국조직공정연구여림상강복
JOURNAL OF CLINICAL REHABILITATIVE TISSUE ENGINEERING RESEARCH
2007年
40期
8201-8204
,共4页
背景:目前,在神经外科手术中主要是应用自体膜及人工硬脑膜做替代材料来修补缺损的硬脑膜,但自体膜取材尺寸及形状受限、手术繁杂、附加创伤等缺点,不符合现代医学发展趋势.目的:对比观察应用新型生物型人工硬脑膜及自体骨膜替代实验动物原生硬脑膜的转归.设计:观察对比实验.单位:广州第一五七医院动物实验中心.材料:选用9只出生6个月的新西兰大白兔.体质量2-3 Kg,雌雄不拘.同时选用12只杂种健康犬,雌雄不拘,犬龄2岁,体质量15-20 Kg.新型硬脑膜(国食药监械字2006第3460627号).方法:实验于2003-10/2005-10于广州第一五七医院动物实验中心完成.实验动物全麻后,双顶开颅,人为制造双侧部分硬脑膜缺损及软脑膜损伤,然后以新型人工硬脑膜及手术区域自体膜分别实施硬脑膜修补术.主要观察指标:分别于实验兔造模后1,6,12个月,每次取3只.实验犬分别于造模后6,12,24个月及病死或终老死亡前,每次取4只.分离暴露植入的替代材料,对比观察大体标本和镜下组织,分析不同时期替代材料的演变过程.结果:纳入实验兔9只及实验犬12只,1只犬麻醉中死亡,其余9只实验兔及11只实验犬均进入结果分析.①大体观察:替代材料替代原生硬脑膜12个月后,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.②组织学观察:实验兔造模后12个月植入新型人工硬脑膜后,植人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.
揹景:目前,在神經外科手術中主要是應用自體膜及人工硬腦膜做替代材料來脩補缺損的硬腦膜,但自體膜取材呎吋及形狀受限、手術繁雜、附加創傷等缺點,不符閤現代醫學髮展趨勢.目的:對比觀察應用新型生物型人工硬腦膜及自體骨膜替代實驗動物原生硬腦膜的轉歸.設計:觀察對比實驗.單位:廣州第一五七醫院動物實驗中心.材料:選用9隻齣生6箇月的新西蘭大白兔.體質量2-3 Kg,雌雄不拘.同時選用12隻雜種健康犬,雌雄不拘,犬齡2歲,體質量15-20 Kg.新型硬腦膜(國食藥鑑械字2006第3460627號).方法:實驗于2003-10/2005-10于廣州第一五七醫院動物實驗中心完成.實驗動物全痳後,雙頂開顱,人為製造雙側部分硬腦膜缺損及軟腦膜損傷,然後以新型人工硬腦膜及手術區域自體膜分彆實施硬腦膜脩補術.主要觀察指標:分彆于實驗兔造模後1,6,12箇月,每次取3隻.實驗犬分彆于造模後6,12,24箇月及病死或終老死亡前,每次取4隻.分離暴露植入的替代材料,對比觀察大體標本和鏡下組織,分析不同時期替代材料的縯變過程.結果:納入實驗兔9隻及實驗犬12隻,1隻犬痳醉中死亡,其餘9隻實驗兔及11隻實驗犬均進入結果分析.①大體觀察:替代材料替代原生硬腦膜12箇月後,兩種替代材料外錶麵與顱骨膜有少許粘連、易分離,與週邊縫閤的原生硬腦膜已完全愈閤,不可分辨,不能分離.從兩種替代材料內錶麵來看,新型人工硬腦膜生長更接近原生硬腦膜,與腦錶麵無粘連或偶有絲狀粘連,而自體骨膜與腦錶麵有絲狀粘連併有少許柱狀粘連.②組織學觀察:實驗兔造模後12箇月植入新型人工硬腦膜後,植人物與宿主之間無嗜中性粒細胞、淋巴細胞等炎癥細胞反應,無囊壁形成.新型人工硬腦膜內錶麵可見上皮細胞覆蓋,上皮下可見纖維組織增生,纖維母細胞增生,植入物被降解,總量明顯減少,內部可見毛細血管. 結論:新型人工硬腦膜的特性使其能產生上皮,不易形成與腦組織的粘連,併逐漸被自體組織蠶食、降解和替代,達到具有實際意義的硬腦膜重建.新型人工硬腦膜在脩補硬腦膜缺損的實際應用中比自體膜有更大優越性.
배경:목전,재신경외과수술중주요시응용자체막급인공경뇌막주체대재료래수보결손적경뇌막,단자체막취재척촌급형상수한、수술번잡、부가창상등결점,불부합현대의학발전추세.목적:대비관찰응용신형생물형인공경뇌막급자체골막체대실험동물원생경뇌막적전귀.설계:관찰대비실험.단위:엄주제일오칠의원동물실험중심.재료:선용9지출생6개월적신서란대백토.체질량2-3 Kg,자웅불구.동시선용12지잡충건강견,자웅불구,견령2세,체질량15-20 Kg.신형경뇌막(국식약감계자2006제3460627호).방법:실험우2003-10/2005-10우엄주제일오칠의원동물실험중심완성.실험동물전마후,쌍정개로,인위제조쌍측부분경뇌막결손급연뇌막손상,연후이신형인공경뇌막급수술구역자체막분별실시경뇌막수보술.주요관찰지표:분별우실험토조모후1,6,12개월,매차취3지.실험견분별우조모후6,12,24개월급병사혹종로사망전,매차취4지.분리폭로식입적체대재료,대비관찰대체표본화경하조직,분석불동시기체대재료적연변과정.결과:납입실험토9지급실험견12지,1지견마취중사망,기여9지실험토급11지실험견균진입결과분석.①대체관찰:체대재료체대원생경뇌막12개월후,량충체대재료외표면여로골막유소허점련、역분리,여주변봉합적원생경뇌막이완전유합,불가분변,불능분리.종량충체대재료내표면래간,신형인공경뇌막생장경접근원생경뇌막,여뇌표면무점련혹우유사상점련,이자체골막여뇌표면유사상점련병유소허주상점련.②조직학관찰:실험토조모후12개월식입신형인공경뇌막후,식인물여숙주지간무기중성립세포、림파세포등염증세포반응,무낭벽형성.신형인공경뇌막내표면가견상피세포복개,상피하가견섬유조직증생,섬유모세포증생,식입물피강해,총량명현감소,내부가견모세혈관. 결론:신형인공경뇌막적특성사기능산생상피,불역형성여뇌조직적점련,병축점피자체조직잠식、강해화체대,체도구유실제의의적경뇌막중건.신형인공경뇌막재수보경뇌막결손적실제응용중비자체막유경대우월성.
BACKGROUND:At present,autogenous periosteum and artificial dura mater are usually applied as the substitute grafts for the dural defect by neurological surgery.However they do not accord with the developing trend of modern medicine,due to the limitations of material size and shape,operational complex and additional wound.OBJECTIVE:To observe and compare the evolution of a new type bio-artificial dura and autogenous periosteum in replacing orthotopic duraDESIGN:Controlled observation and trial.SETTING:Animal Testing Center in the 157 Hospital of Guangzhou City.MATERIALS:Nine New Zealand rabbits.aged 6 months and weighed 2-3 kg,either gender was selected.Twelve hybrid healthy dogs of both genders,aged 2 years and weighed 15-20 kg.New type dura mater(No.2006.3460627).METHODS:The experiment was carried out at the Animal Testing Center in the 157 Hospital of Guangzhou City from October 2003 to October 2005.After the general anesthesia and bilateral craniotomy,the bilateral dural defect and pia mater injury were induced partly,then dural neoplasty was performed using new type artificial dura and autogenous periosteum.MAIN OUTCOME MEASURES:At months 1,6,12 of modeling,each three rabbits were selected to isolate and expose the implanted materials,while each four dogs were selected at months 6,12,24 of modeling,died of disease or prior to death.General observation and microscopic assessment of samples were compared to analyze the development of implanted materials at difference stages.RESULTS:Except one experimental dog died during the anesthesia,9 rabbits and 11 dogs were involved in the final presented the extemal surface of adherence and separation with pedcranium,grew well with surrounding orthotopic dura.For the internal surface of materials,the new type artificial dura was more likely the orthotopic dura and did no adhere to pericranium, and filament-shaped adherence appeared occasionally, while there were filament-shaped even month 12 of grafting new type artificial dura into the experimental rabbits.inflammatory cellular reactions such as neutrophil and lymphocyte were not found,additionally no capsule wall formation occurred.The internal surface of artificial dura was covered with epithelial cells,which appeared fibroplasia,fibroblast proliferation,degradation of implants and obvious reduction of total cell amount.Moreover the blood capillary was also found.CONCLUSION:New type artificial dura can achieve the dural reconstruction through producing epithelial cells and being nibbled.degraded and substituted by autogenous tissue.And no adherence to cerebral tissues is found.New type artificial dura is superior to autogenous periosteum for repairing the dural defects.
