本文關(guān)鍵詞：球周注射殼聚糖甘油磷酸二鈉對實驗性白兔后鞏膜的加固作用　出處：《陜西中醫(yī)學(xué)院》2010年碩士論文　論文類型：學(xué)位論文

  更多相關(guān)文章： 球周注射 殼聚糖甘油磷酸二鈉 后鞏膜加固 生物相容性 組織病理

【摘要】： 目的:探討球周注射殼聚糖甘油磷酸二鈉對實驗性白兔后鞏膜的加固效果。 方法: 1選用大耳白兔20只,雌雄各半,體重2-2.5kg,隨機抽取5只為對照組。其余動物為處理組,均以左眼為手術(shù)眼。用注射器套自制的鈍性針頭,由切口處進(jìn)針,沿筋膜下間隙緊貼著鞏膜向后進(jìn)針3mm-4mm,注入殼聚糖甘油磷酸二鈉1.2ml-1.5ml。術(shù)畢用慶大地米注射液沖洗結(jié)膜囊,涂紅霉素眼膏,包扎術(shù)眼。 2術(shù)后正�；顒印⒍〞r飲食,測實驗動物0h、24h、48h、72h餐前身體重量,計算每日重量改變量。 3術(shù)后2、4、8周測眼壓、眼底熒光血管造影、眼眶CT、眼A超、眼B超。之后耳緣靜脈注入空氣處死白兔,冰凍兔頭12小時后用自制小鋸條沿兔眼眶做冠狀切面和矢狀切面,其余動物摘除眼球,沖洗干凈,切取混合鞏膜組織,先肉眼觀察,再分別以10%福爾馬林液固定,石蠟包埋切片,HE染色,光鏡觀察。 結(jié)果: 1 C/GP生物相容性:球周注射C/GP引起眼部輕度炎癥反應(yīng)。 2眼壓測量結(jié)果:術(shù)后2周、4周、8周,2周組與對照組左眼眼壓比較沒有統(tǒng)計差異(P0.05);2周組和4周組比較沒有統(tǒng)計學(xué)差異(P0.05);4周、8周組較對照組左眼眼壓升高,有統(tǒng)計學(xué)差異(P0.05);2周和8周組比較,8周組眼壓升高,有統(tǒng)計學(xué)差異(P0.05);4周和8周組比較,8周組眼壓升高,有統(tǒng)計學(xué)差異(P0.05);右眼各組間2、4、8周眼壓比較沒有統(tǒng)計學(xué)差異(P0.05)。 3眼軸測量結(jié)果:動物眼部球周注射C/GP對眼軸影響較對照組無統(tǒng)計學(xué)差異(P0.05);術(shù)后2、4、8周左眼眼軸比較無統(tǒng)計學(xué)差異(P0.05),右眼眼軸比較無統(tǒng)計學(xué)差異(P0.05),左眼和右眼眼軸比較無統(tǒng)計學(xué)差異(P0.05)。 4眼眶CT檢查結(jié)果:2周組左眼后極部偏顳上方鞏膜較對照組左眼顯著增厚,形成一規(guī)則環(huán)狀“新鞏膜”,密度均勻,與鞏膜密度大致相同,低于眶骨密度,其與周圍眼眶間隙清晰,視神經(jīng)清晰規(guī)整。 5 B超檢查結(jié)果:術(shù)后2周B超見左眼后部顳上方后鞏膜有不規(guī)則條狀低回聲區(qū),術(shù)后4周后此低回聲區(qū)變?yōu)樵卵罓顝娀芈晠^(qū),術(shù)后8周此強回聲區(qū)減弱,后部鞏膜回聲均勻一致,玻璃體未見異�；芈�,視網(wǎng)膜回聲規(guī)整,視神經(jīng)回聲規(guī)整,眶內(nèi)未見異常回聲。 6冰凍眼球切面結(jié)果:術(shù)后8周冰凍眼球切面見,龍膽紫染色組織均勻地貼附于后部鞏膜上,并與鞏膜融為一體,與周圍組織間隙清楚。 7鞏膜組織病理學(xué)觀察結(jié)果:術(shù)后2周見,鞏膜表層膠原纖維排列粗細(xì)不均,炎性細(xì)胞增加,新生血管增生。術(shù)后4周見鞏膜表層肉芽組織增生,新生血管增生。術(shù)后8周見后鞏膜膠原纖維增粗,排列整齊,肉芽組織增生,后鞏膜增厚。 8眼底熒光血管造影觀察結(jié)果:對照組與實驗組眼底熒光造影未發(fā)現(xiàn)明顯變化。 結(jié)論: 1殼聚糖甘油磷酸二鈉在眼部球周注射的炎性反應(yīng)很小,生物相容性較好,可作為后鞏膜加固術(shù)的一種新型材料。 2球周注射殼聚糖甘油磷酸二鈉改變了鞏膜的硬度及彈性,但對眼軸的影響不大。 3殼聚糖甘油磷酸二鈉混合物球周注射后能夠均勻的在球后鞏膜分布,并與鞏膜緊密的貼附,支撐著后鞏膜。 4球周注射物對視網(wǎng)膜脈絡(luò)膜及玻璃體無影響;殼聚糖甘油磷酸二鈉與鞏膜融合后發(fā)生炎癥反應(yīng),新生血管增生,肉芽組織增生,膠原纖維增粗,排列整齊,鞏膜重新塑形。
[Abstract]:Objective: To investigate the effect of two sodium chitosan glycate phosphate on the posterior sclera of experimental rabbits.
Method:
1 selected 20 rabbits, male and female, weight 2-2.5kg, 5 rats were randomly selected as control group. The animal is the treatment group in the left eye for eye surgery. Blunt needle made with a syringe sleeve, the incision into the needle, along the fascia gap close to the scleral backward 3mm-4mm needle, injecting shell the chitosan glycerol phosphate sodium two 1.2ml-1.5ml. after operation Yongqing meters earth irrigating conjunctival sac injection, with Erythromycin Eye Ointment, bandaging the eye.
2 normal activities after operation, regular diet, test the body weight of 0h, 24h, 48h, 72h before meal, and calculate the daily weight change.
2,4,8 intraocular pressure measurement after 3 weeks, fundus fluorescein angiography, orbital CT, A eye ultra, B-ultrasonography. After ear vein injection of air to kill rabbits, frozen rabbit after 12 hours with a homemade small blade along the rabbit orbital coronal and sagittal plane, the remaining animal removal of the eye, rinse, cut mixed scleral tissue first, the naked eye, then in 10% formalin fixed, paraffin section, HE staining, light microscopy.
Result:
1 C/GP biocompatibility: a mild inflammation of the eye caused by a weekly injection of C/GP.
2 intraocular pressure measurements: 2 weeks after surgery, 4 weeks, 8 weeks, 2 weeks group and the control group has no statistical difference in IOP between the left eye (P0.05); no statistical differences between the 2 week and 4 week group (P0.05); 4 weeks and 8 weeks group than in the control group increased intraocular pressure of the left eyes, there were significant differences (P0.05); 2 and 8 weeks group, 8 weeks group elevated intraocular pressure, there was significant difference (P0.05); 4 and 8 weeks group, 8 weeks group elevated intraocular pressure, there were significant differences between the groups (P0.05); the right eye 2,4,8 weeks intraocular pressure is not statistically significant (P0.05).
3 axis measurement results: animal eye peribulbar injection of C/GP on axial than in the control group had no significant difference (P0.05); 2,4,8 weeks after surgery the left eye axis had no significant difference (P0.05), right eye axis had no significant difference (P0.05), the left and right eye axis had no significant difference (P0.05).
4 orbital CT findings: the 2 week group had thickened sclera on the upper temporal part of the left eye. Compared with the control group, the left eye was thickened, forming a regular new sclera. The density was homogeneous, and the density of sclera was almost the same as that of the sclera, which was lower than that of the orbital bone. The density of the sclera was clear with the surrounding orbital clearance, and the optic nerve was clear and regular.
5 ultrasound examination results: 2 weeks after operation the left rear B see above the posterior temporal irregular strip low echo area, after 4 weeks after the low echo area into echodensities crescent, decreased 8 weeks after operation Ciqiang echo area, posterior sclera echo uniform, vitreous body retina no abnormal echo, echo regular, optic echo regular, no abnormal echo in the orbit.
Results: 6 frozen section of the eyeball eyeball section frozen after 8 weeks, crystal violet staining of tissue uniformly attached to the posterior sclera and the sclera, and blend with the surrounding tissue space clear.
The observation results of 7 scleral tissue pathology: 2 weeks after operation, the surface sclera collagen fibers were uneven thickness, increase in inflammatory cells and neovascularization. The surface sclera hyperplasia of granulation tissue at 4 weeks after operation, neovascularization. After 8 weeks after scleral collagen fiber thickening, arranged neatly in granulation tissue hyperplasia of posterior scleral thickening.
The results of 8 fundus fluorescein angiography showed that the contrast group and the experimental group had no obvious changes in fundus fluorescein angiography.
Conclusion:
The inflammatory response of 1 chitosan glyceryl phosphate two sodium in the eye sphere is very small and has good biocompatibility. It can be used as a new material for the reinforcement of the posterior sclera.
The hardness and elasticity of the sclera were changed by injection of chitosan glyceric phosphoric acid two in 2 weeks, but there was little effect on the eye axis.
The 3 chitosan glyceryl phosphate two sodium mixture can be evenly distributed in the posterior sclera after the ball injection and adhered closely with the sclera, supporting the posterior sclera.
4, there was no effect on the retina choroid and vitreous by injecting the ball around the ball. After the fusion of chitosan glycerol phosphate two sodium and sclera, inflammatory reaction, neovascularization, granulation tissue hyperplasia, collagen fiber thickening, orderly arrangement and sclera remodeling were achieved.

【學(xué)位授予單位】：陜西中醫(yī)學(xué)院
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2010
【分類號】：R779.6

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