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Experimental Study on Prevention Adhesion after Orbital Blowout Fracture Repaired by Man-made Plates of Amniotic Membrane

Author: ZhuQi
Tutor: XiaoLiHua
School: Hebei Medical University
Course: Ophthalmology
Keywords: Orbital blowout fracture Animal models Amniotic Adhesions TGF-β Image analysis
CLC: R779.6
Type: Master's thesis
Year: 2008
Downloads: 26
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Abstract

Objective: To investigate the preventive effect of amniotic orbital blowout fracture, soft tissue injury caused by adhesions, observe the optic nerve histopathology. Method: adult New Zealand rabbits 26, 10 is placed in the bone piece a week after the observation group, 10 for placement of bone chips Observer Group in January. Adopt self-control method right eye and the left eye as a control group for the experimental group. The remaining six blank control group. Established animal models of orbital fractures by 1.2cm × 1.2cm size bone defects in rabbit eyes above the lacrimal bone caused by and cause human trauma and its corresponding orbital soft tissue model effects by postoperative CT imaging evaluation. The experimental group through the the HA bone plate implant wrapped amniotic repair, control group implanted directly into the the HA bone slices repair, blank group without any treatment. Put into a piece of bone, respectively one week in January after the animals were killed, conduct visual observation adhesions, pathology score polarized collagen fiber content determination, immunohistochemical staining of transforming growth factor (TGF-β), and through the image The analysis determined the average optical density, light area, integrated optical density analysis of the significant difference between the three groups of two observation points, and ultimately to evaluate this approach. Adhesion severity score, the inflammatory reaction classification results using multiple sample nonparametric rank sum test (Kruskal-Wallis Test). Immunohistochemical image analysis results using one-way ANOVA and SNK-q test. P lt; 0.05 There are significant. Results: 1, general observation: one week after the 1.1 implantable bone piece, the degree of adhesion grading the results of the control group 4 5 3 3 2 points 2; experimental group 3, 3 points 4 2 points 3; blank group 1, 3 1 2 4 1 1. The statistical results show that adhesion classification differences between the experimental group and the control group without statistical significance (p gt; 0.05). Adhesions between the control group and the experimental group and control group difference was statistically significant (p lt; 0.05) grading. 1.2 implantable bone slices after January, scoring results control group 4 3 3 5 2 points 2; experimental group, a 4 3 3 2 points 4 , 2; blank group 4 0 3 2 2 3 1 1 minute. The statistical results showed that the adhesion between the control group and the experimental group and the control group, the difference was statistically significant (p lt; 0.05) grading. The difference was not statistically significant (p gt; 0.05) of the control group and the experimental group adhesion grading. Morphological changes one week after the 2.1 implantable bone piece, the the inflammation score results for the control group 5, 2 points 4 points a; experimental group 3 4 2 3 1 2 0 1 eye; blank group 3 1 2 points 2 points 2 0 1. The statistical results showed that the difference was not statistically significant (p gt; 0.05) the extent of the experimental group and the control group, inflammatory reaction. The differences between the control group and the experimental group and the control group, the inflammatory response was statistically significant (p lt; 0.05). 2.2 implantable bone chips in January, the control group 3 3 2 points 4 points 3; experimental group 3 0 2 3 1 4 0 3 ; blank group 3 points 0 and 2 points 2 points 3 0 1. The statistical results showed that the difference was statistically significant (p lt; 0.05) the extent of the control group and the experimental group and the control group inflammatory reaction. Inflammatory response degree of the control group and the experimental group was not statistically significant (p gt; 0.05). 3 collagen assessment 3.1 week after the implantation of bone slices, three groups around the piece of bone hyperplasia fiber irregular, most highly refractive yellow or red type I collagen fibers constitute a wide area, interspersed weakly refraction green fine fibers, type III collagen fibers, periosteum area show the yellow fibers closely spaced, the experimental group and the control group had no significant difference. 3.2 implantable bone chip in January, the experimental group around the bone slices hyperplasia fiber alignment rules visible evenly distributed refractive strong yellow type I collagen fibers under polarizing microscope, during which the distribution area of ??a wide range of type III collagen fibers for refractive Sexual weak green fiber. The control group compared to the type I collagen content of the experimental group increased, Ⅲ collagen type fiber content reduced, form more coarse. Week 4, the results of immunohistochemical 4.1 implantable bone chip, the experimental and control groups strongly positive brown granules many deep and dense, coloring, widely distributed in the proliferation of soft tissue. Brown blank group positive particles less light color. 4.2 implantable bone chip in January, very little positive granules in the experimental group and the control group brown, with pale, distributed in the outer membrane of fibrous tissue; distribution of brown particles within the control group was the stove positive, medium density, deep coloring, distribution In the region of fibronectin organization and the inflammatory response. Week 5, 5.1 implantable bone chip image analysis results, the control group, than positive particles surface density in the experimental group, the integrated optical density slightly higher positive area ratio between the two does not have a significant difference (p gt; 0.05). Blank control group and the two groups have a significant difference (p lt; 0.05) 5.2 implant bone slices in January, the surface density distribution of positive particles in the control group, the integrated optical density, the high rate of positive area in the experimental group and the blank control group, compared with a significant difference (p lt; 0.01) was statistically significant. 6, optic nerve pathology observed three sets of soft tissue around the optic nerve alignment rules, no visible lesions; obvious fibrous tissue and infiltration of inflammatory cells around the optic nerve sheath; the arachnoid lacunar visible, no obvious increase in the cell; optic nerve fibers go line rules, no obvious degeneration and gliosis. Conclusion: pathophysiological process by causing a fracture on the wall of the rabbit orbital defect, soft tissue injury, the best possible simulation of the human orbital blowout fracture. Modeling results, the operation is simple, easy to grasp, economical and practical. Amniotic membrane wrapped piece of bone on the orbital fracture repair, after early surgery (within a week) and no amniotic obvious anti-inflammatory effects, but the latter part of the damage repair (January) can be observed to amniotic significant anti-inflammatory and anti-adhesion role. 3 amniotic membrane wrapped piece of bone repair orbital fractures safe and effective. Such as ocular trauma in 4 clinical range of orbital fractures, adhesions heavier, or old fracture patients require secondary surgery, which involve the use of filler repair to prevent adhesions amniotic membrane wrapped filler transplantation can be considered.

Experimental Study on Prevention Adhesion after Orbital Blowout Fracture Repaired by Man-made Plates of Amniotic Membrane

Abstract

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