宋跃明,
Email: 442326621@qq.com
椎板切除术后硬膜外瘢痕粘连是脊柱外科常见并发症，研究认为硬膜外瘢痕粘连与腰椎手术失败综合征密切相关。根据不同文献报道，5%～60% 的腰椎手术失败综合征是硬膜外瘢痕粘连引起的。硬膜外瘢痕粘连会大大增加再次手术的风险，治疗效果也不理想。所以，找寻一种更加安全合理的预防方法一直是脊柱外科研究的重点。自体组织、天然高分子等作为物理屏障阻隔硬模外瘢痕的方法已使用了几十年，取得了一定疗效。近年来随着对硬膜外瘢痕粘连机制的认识以及材料学的发展，新的方法层出不穷。自体组织、天然高分子及人工合成高分子等生物材料在动物实验甚至临床上取得了一定进展。该文对近年国内外有关生物材料在预防硬膜外瘢痕粘连的研究进展进行了综述。
Citation：
吕超亮, 宋跃明.
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- 2. Isla A, Alvarez F. Spinal epidural fibrosis following lumbar diskectomy and antiadhesion barrier. Neurocirugia (Astur), 2001, 12(5): 439-446.
- 3. 杨述华. 实用脊柱外科学. 北京: 人民军医出版社, 2004: 907-915.
- 4. 尹海磊, 尹海霞, 卢廷胜, 等. 预防椎板切除术后硬膜外瘢痕粘连材料的研究进展. 中国矫形外科杂志, 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. Eseoğlu M, Akdemir H. Failed back surgery syndrome in lomber disc herniation: the retrospectıve analysis of success scorings of epidural fibrosis and recurrent cases in reoperations. Eur J General Med, 2010, 7(2): 130-135.
- 7. 张萍. 早期康复护理预防腰椎间盘突出症术后神经根粘连. 华西医学, 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. 王欢, 郝立波, 王海义. 血肿在硬膜外瘢痕粘连形成中作用的探讨. 中华骨科杂志, 1998, 18(3): 161-163.
- 12. 张铁洪, 谢金瑞, 杜江鸿. 预防椎板切除术后硬膜外粘连形成55例体会. 中国医师杂志, 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. 蒋尧传, 唐志宏, 辛桂桐, 等. 腰椎术后硬膜外瘢痕粘连6例原因分析. 中国骨与关节损伤杂志, 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.
- 16. Ono I, Yamashita T, Hida T,et al. Local administration of hepatocyte growth factor gene enhances the regeneration of dermis in acute incisional wounds. J Surg Res, 2004, 120(1): 47-55.
- 17. 任丽虹, 郝立君, 肖志波, 等. 结缔组织生长因子反义寡核苷酸对人增生性瘢痕成纤维细胞结缔组织生长因子表达及胶原合成的作用. 中国临床康复, 2006, 10(16): 92-94.
- 18. 李学森, 邹云雯, 褚言琛, 等. IL-1β抑制硬膜外瘢痕形成的作用与机制研究. 中国矫形外科杂志, 2010, 18(10): 849-852.
- 19. Lotz MM, Rabinovitz I, Mercurio AM. Intestinal restitution: progression of actin cytoskeleton rearrangements and integrin function in a model of epithelial wound healing. Am J Pathol, 2000, 156(3): 985-996.
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