CAJ | 학술논문

目的：应用不同交联程度的牛心包生物补片行后巩膜加固术，观察实验动物巩膜加固区的力学特性，并进一步探讨后巩膜加固术的作用机制。方法健康成年纯种新西兰白兔48只，雌雄不拘。体重2．2～2．5 kg，随机分为4组，每组12只。 A组使用未交联的牛心包生物补片；B组使用中度交联的牛心包生物补片；C组使用高度交联的牛心包生物补片；D组使用人巩膜组织。分别分为术后2、4、12、24周观察期。手术前常规裂隙灯、间接检眼镜检查，排除有眼部疾患的动物。同期手术，各组术眼为左眼。后巩膜加固材料为长条形，5 mm ×20 mm，每眼植入1条。手术前后观察外眼（结膜水肿、炎性反应）、前节、眼底情况。各组手术后2、4、12、24周取标本，摘除眼球，洗净血污，切取植片包括其附着的巩膜。应用BOSE ElectroForce动态力学试验仪对各不同交联度牛心包补片及各实验组巩膜加固区进行生物力学检测。结果随植入时间的延长，A、D组组织逐渐被降解吸收，至24周时已大部被吸收。 B、C组组织无明显降解。 A、D组术后4、12周巩膜加固区的弹性模量和刚度与术后2周相比明显增大，刚度及强度则随着术后时间延长而下降。 B、C组术后24周巩膜加固区的弹性模量较其余各时间点减少，术后12周与24周组刚度明显降低，尤其以术后24周组刚度最弱。术后24周 B、C组刚度及强度明显高于A、D组，差异有统计学意义（P＜0．05）。结论交联后的牛心包机械强度大大提高，中、高度交联的牛心包均可用于后巩膜加固术，其远期效果优于人巩膜及未交联的牛心包。
목적：응용불동교련정도적우심포생물보편행후공막가고술，관찰실험동물공막가고구적역학특성，병진일보탐토후공막가고술적작용궤제。방법건강성년순충신서란백토48지，자웅불구。체중2．2～2．5 kg，수궤분위4조，매조12지。 A조사용미교련적우심포생물보편；B조사용중도교련적우심포생물보편；C조사용고도교련적우심포생물보편；D조사용인공막조직。분별분위술후2、4、12、24주관찰기。수술전상규렬극등、간접검안경검사，배제유안부질환적동물。동기수술，각조술안위좌안。후공막가고재료위장조형，5 mm ×20 mm，매안식입1조。수술전후관찰외안（결막수종、염성반응）、전절、안저정황。각조수술후2、4、12、24주취표본，적제안구，세정혈오，절취식편포괄기부착적공막。응용BOSE ElectroForce동태역학시험의대각불동교련도우심포보편급각실험조공막가고구진행생물역학검측。결과수식입시간적연장，A、D조조직축점피강해흡수，지24주시이대부피흡수。 B、C조조직무명현강해。 A、D조술후4、12주공막가고구적탄성모량화강도여술후2주상비명현증대，강도급강도칙수착술후시간연장이하강。 B、C조술후24주공막가고구적탄성모량교기여각시간점감소，술후12주여24주조강도명현강저，우기이술후24주조강도최약。술후24주 B、C조강도급강도명현고우A、D조，차이유통계학의의（P＜0．05）。결론교련후적우심포궤계강도대대제고，중、고도교련적우심포균가용우후공막가고술，기원기효과우우인공막급미교련적우심포。
Objective To evaluate the biomechanical properties of bovine pericardium ( BP) after posterior sclera reinforce-ment operation ( PSR) ,and to investigate the mechanism of PSR further in the experimental animal and to provide reference for further clinical test and application.Methods Forty-eight New Zealand albino rabbits, weighing 2.2 to 2.5 kg, underwent posterior sclera reinforcement operation of the left eye.All eyes were examined preoperatively by slit lamp biomicroscopy and indirect ophthalmoscopy, and only healthy eyes were included in the experiment.Animals were randomized into 4 groups.For each group, one type of material was surgically implanted at the back of the globe.Group A: uncrosslinked BP ( UBP ) group, 12 rabbits; group B: moderate crosslinked BP MBP group, 12 rabbits.Group C:high crosslinked BP HBP group, 12 rabbits.Group D:human sclera group, 12 rab-bits.The eyes were enucleated at the 2nd, 4th, 12th and 24th week after surgery respectively.The mechanic properties of four groups were evaluated by the BOSS ElectroForce BioDynamic test instruments.Results The patches in group A and D degraded with time and degraded mostly at the time of 24th week after surgery.The patches were intact in group B and C.Statistically significant differ-ence in modulus of elasticity of implanted area of sclera samples was noticed between the time of 4th, 12th week and 2nd week after surgery in group A and D, and the stiffness and breaking strength decreased with time.The modulus of elasticity of implanted area of sclera in group B and C decreased at the 24th week after surgery, the stiffness decreased at the 12th and 24th week after surgery, espe-cially at the time of 24th week.Statistically significant difference in stiffness and breaking strength was noticed between groups A, D and groups B, C at the time of 24th week after surgery.Conclusions The study revealed that MBP and HBP effectively enhances the anti-deformation capacity of the posterior sclera in rabbits and surpasses the BP without crosslink and human sclera .The MBP and HBP may add to our repertoire in preventing the development of progressive myopia.