宋躍明,
Email: 442326621@qq.com
椎板切除術后硬膜外瘢痕粘連是脊柱外科常見并發癥，研究認為硬膜外瘢痕粘連與腰椎手術失敗綜合征密切相關。根據不同文獻報道，5%～60% 的腰椎手術失敗綜合征是硬膜外瘢痕粘連引起的。硬膜外瘢痕粘連會大大增加再次手術的風險，治療效果也不理想。所以，找尋一種更加安全合理的預防方法一直是脊柱外科研究的重點。自體組織、天然高分子等作為物理屏障阻隔硬模外瘢痕的方法已使用了幾十年，取得了一定療效。近年來隨著對硬膜外瘢痕粘連機制的認識以及材料學的發展，新的方法層出不窮。自體組織、天然高分子及人工合成高分子等生物材料在動物實驗甚至臨床上取得了一定進展。該文對近年國內外有關生物材料在預防硬膜外瘢痕粘連的研究進展進行了綜述。
Citation：
呂超亮, 宋躍明.
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- 1. Gasiński P, Radek M, Jó?wiak J,et al. Peridural fibrosis in lumbar disc surgery——pathogenesis, clinical problems and prophylactic attempts. Neurol Neurochir Pol, 2001, 34(5): 983-993.
- 2. Isla A, Alvarez F. Spinal epidural fibrosis following lumbar diskectomy and antiadhesion barrier. Neurocirugia (Astur), 2001, 12(5): 439-446.
- 3. 楊述華. 實用脊柱外科學. 北京: 人民軍醫出版社, 2004: 907-915.
- 4. 尹海磊, 尹海霞, 盧廷勝, 等. 預防椎板切除術后硬膜外瘢痕粘連材料的研究進展. 中國矯形外科雜志, 2011, 19(17): 1456-1458.
- 5. Hemmo A, James E. Incidence and severity of epidural fibrosis after back surgery: an endoscopic study. Pain Practice, 2010, 10(1): 18-24.
- 6. Eseo?lu M, Akdemir H. Failed back surgery syndrome in lomber disc herniation: the retrospect?ve analysis of success scorings of epidural fibrosis and recurrent cases in reoperations. Eur J General Med, 2010, 7(2): 130-135.
- 7. 張萍. 早期康復護理預防腰椎間盤突出癥術后神經根粘連. 華西醫學, 2012, 27(7): 1077-1078.
- 8. Key JA, Ford LT. Experimental intervertebral disc lesion. J Bone Joint Surg Am, 1948, 30(3): 621-630.
- 9. LaRocca H, Macnab I. The laminectomy membrane. Studies in its evolution, characteristics, effects and prophylaxis in dogs. J Bone Joint Surg (Br), 1974, 56(3): 545-550.
- 10. Robertson T. Role of peridural fibrosis in the failed back: a review. Eur Spine J, 1996, 5(Suppl 1): S2-S6.
- 11. 王歡, 郝立波, 王海義. 血腫在硬膜外瘢痕粘連形成中作用的探討. 中華骨科雜志, 1998, 18(3): 161-163.
- 12. 張鐵洪, 謝金瑞, 杜江鴻. 預防椎板切除術后硬膜外粘連形成55例體會. 中國醫師雜志, 2001, 3(2): 137.
- 13. Lee JY, Stenzel W, Ebel H,et al. Mitomycin C in preventing spinal epidural fibrosis in a laminectomy model in rats. J Neurosurg, 2004, 100(1 Suppl Spine): 52-55.
- 14. 蔣堯傳, 唐志宏, 辛桂桐, 等. 腰椎術后硬膜外瘢痕粘連6例原因分析. 中國骨與關節損傷雜志, 2005, 20(3): 178-179.
- 15. Einhaus L, Robertson T, Dohan C,et al. Reduction of peridural fibrosis after lumbar laminotomy and discectomy in dogs by a resorbable gel (ADCON-L). Spine (Phila Pa 1976), 1997, 22(13): 1440-1446; discussion 1446-1447.
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