CAJ | 학술논문

背景:二维平面角度已证实医用自交联透明质酸钠凝胶能够在术后8周有效预防兔椎板切除后硬膜外粘连的发生.目的:应用Micro-CT联合硬膜外造影技术观察和评估自交联透明质酸钠凝胶预防椎板切除后硬膜外粘连的可行性.方法:将18只L5椎板全切除的新西兰大白兔随机分组:对照组用生理盐水冲洗术区后关闭切口;HyaRegen/SPⅠ组用医用自交联透明质酸钠凝胶HyaRegen/SPⅠ0.5 mL覆盖暴露硬脊膜后关闭切口;HyaRegen/SPⅡ组用医用自交联透明质酸钠凝胶HyaRegen/SPⅡ0.5 mL覆盖暴露硬脊膜后关闭切口.结果与结论:各组体感诱发电位潜伏期均无明显延长,3组间差异无显著性意义(P>0.05).Micro-CT联合硬膜外造影扫描并三维重建后显示,HyaRegen/SPⅠ组及 HyaRegen/SPⅡ组对比剂能够顺利充盈硬膜外间隙,对照组对比剂充盈不顺畅,在术区局部形成多处充盈缺损.HyaRegen/SPⅠ组及 HyaRegen/SPⅡ组术区硬脊膜外单位体积内对比剂充盈体积均高于对照组(P <0.05),前2组间差异无显著性意义(P >0.05).对照组硬膜外粘连程度要远高于HyaRegen/SPⅠ组及HyaRegen/SPⅡ组(P<0.05).证实医用自交联透明质酸钠凝胶可有效预防兔椎板切除后硬膜外粘连的发生,应用Micro-CT联合硬膜外造影技术能有效观察和评估硬膜外粘连.
배경:이유평면각도이증실의용자교련투명질산납응효능구재술후8주유효예방토추판절제후경막외점련적발생.목적:응용Micro-CT연합경막외조영기술관찰화평고자교련투명질산납응효예방추판절제후경막외점련적가행성.방법:장18지L5추판전절제적신서란대백토수궤분조:대조조용생리염수충세술구후관폐절구;HyaRegen/SPⅠ조용의용자교련투명질산납응효HyaRegen/SPⅠ0.5 mL복개폭로경척막후관폐절구;HyaRegen/SPⅡ조용의용자교련투명질산납응효HyaRegen/SPⅡ0.5 mL복개폭로경척막후관폐절구.결과여결론:각조체감유발전위잠복기균무명현연장,3조간차이무현저성의의(P>0.05).Micro-CT연합경막외조영소묘병삼유중건후현시,HyaRegen/SPⅠ조급 HyaRegen/SPⅡ조대비제능구순리충영경막외간극,대조조대비제충영불순창,재술구국부형성다처충영결손.HyaRegen/SPⅠ조급 HyaRegen/SPⅡ조술구경척막외단위체적내대비제충영체적균고우대조조(P <0.05),전2조간차이무현저성의의(P >0.05).대조조경막외점련정도요원고우HyaRegen/SPⅠ조급HyaRegen/SPⅡ조(P<0.05).증실의용자교련투명질산납응효가유효예방토추판절제후경막외점련적발생,응용Micro-CT연합경막외조영기술능유효관찰화평고경막외점련.
BACKGROUND: Medical self-crosslinked sodium hyaluronate gel can effectively prevent epidural adhesions after laminectomy in rabbits within 8 weeks after operation, which has been confirmed by planar angle. OBJECTIVE:To observe and evaluate the practicability of self-crosslinked sodium hyaluronate gel in preventing epidural adhesions by using Micro-CT combined with epidurography. METHODS:Eighteen new Zealand white rabbits with total lumbar laminectomy at L5 level were randomly divided into three groups:control, HyaRegen/SPⅠ and HyaRegen/SPⅡ groups. In the control group, only normal saline was used to flush the laminectomy area before wound closure, while in HyaRegen/SPI and HyaRegen/SPⅡ groups, the exposed dura mater was covered with 0.5 mL HyaRegen/SPI or 0.5 mL HyaRegen/SPII, respectively before wound closure. RESULTS AND CONCLUSION:The latency of cortical somatosensory evoked potentials was not delayed obviously in each group, and there was no significant difference in the three groups (P>0.05). The scanning of Micro-CT combined with epidurography and the images of three-dimensional reconstruction showed that contrast agent could fil the epidural space smoothly in the HyaRegen/SPⅠ and HyaRegen/SPⅡ groups, but not in the control group, and many fil ing defects in local operation area could been observed. In addition, the fil ing volume of contrast agent of the HyaRegen/SPⅠ and HyaRegen/SPⅡ groups in the unit volume of operation area was higher than that in the control group (P<0.05). There was no significant difference between HyaRegen/SPI and HyaRegen/SPⅡ groups (P>0.05). Moreover, the degree of epidural adhesions of the control group was significantly higher than that in the HyaRegen/SPI and HyaRegen/SPⅡ groups (P<0.05). These findings suggest that medical self-crosslinked sodium hyaluronate gel can effectively prevent epidural adhesions after laminectomy in rabbits. Besides, epidural adhesions can be observed and evaluated effectively by using Micro-CT combined with epidurography.