CAJ | 학술논문

目的：观察聚-DL-乳酸（PDLLA）可吸收生物膜联合丹参预防腰椎术后硬膜外粘连的效果。方法将60只新西兰白兔随机均分成5组，施以L5-L7全椎板切除术，A组放置明胶海绵片，B组明胶海绵片+丹参注射液，C组PDLLA可吸收膜，D组明胶海绵片+丹参注射液+PDLLA可吸收膜，E组空白对照组不作特殊处理，于术后2周、4周、8周、12周分别行肉眼大体观察、电镜观察瘢痕生长及硬膜外粘连情况。结果 B组、C组和D组有非常明显防粘连效果，与E组及A组之间存在显著性差异（P＜0.05），虽然B组，C组和D组之间在防粘连效果方面无显著差异（P＞0.05），但D组的防粘连效果更为突出，直到12周时电镜下成纤维细胞和胶原纤维仍呈现生长缓慢，排列紊乱和结构疏松的镜像。结论丹参+PDLLA可吸收膜有很好的三维防粘连效果，可作为理想的预防硬膜外粘连材料。
목적：관찰취-DL-유산（PDLLA）가흡수생물막연합단삼예방요추술후경막외점련적효과。방법장60지신서란백토수궤균분성5조，시이L5-L7전추판절제술，A조방치명효해면편，B조명효해면편+단삼주사액，C조PDLLA가흡수막，D조명효해면편+단삼주사액+PDLLA가흡수막，E조공백대조조불작특수처리，우술후2주、4주、8주、12주분별행육안대체관찰、전경관찰반흔생장급경막외점련정황。결과 B조、C조화D조유비상명현방점련효과，여E조급A조지간존재현저성차이（P＜0.05），수연B조，C조화D조지간재방점련효과방면무현저차이（P＞0.05），단D조적방점련효과경위돌출，직도12주시전경하성섬유세포화효원섬유잉정현생장완만，배렬문란화결구소송적경상。결론단삼+PDLLA가흡수막유흔호적삼유방점련효과，가작위이상적예방경막외점련재료。
Objective To observe the effect of using poly-DL-lactic acid (PDLLA) compound biomembrane and salvia miltior-rhiza for preventing peridural adhesion after lumbar laminectomy in rabbits. Methods 60 New Zealand rabbits were averagely di-vided into 5 groups for this study,which had been executed total laminectomy at the L5-L7 levels and covered and filled into lami-na defect by the gelatin sponge (Group A),the gelatin sponge + the salvia miltiorrhiza injection (Group B),the PDLLA compound biomembrane(Group C) and the gelatin sponge+the salvia miltiorrhiza injection+the PDLLA compound biomembrane(Group D), respectively. There was no mem-brane being used in the contrast group (Group E). Gross naked eye and electron microscope ob-servation were performed to evaluate the growing rate of scars and the degree of peridural adhesion at 2 weeks,4 weeks,8 weeks and 12 weeks after operation,respectively. Results There were significantly anti-adhesion effect in the B,C and D groups,and there was significant difference compare with the E group and the A group(P<0.05),although there were no significant difference a-mong the B,C,D groups (P>0.05),but in the D group,it has more excellent anti-adhesion,the fibroblasts and the collagen fibers was still observed slow growth,disorganized and loose by electron microscope until 12 weeks after operation. Conclusion The salvia miltiorrhiza+the PDLLA compound biomembrane can achieve excellent three-dimensional anti-adhesion effect,it can be used as an ideal material for prevention of epidural adhesions.