局部应用他克莫司预防硬膜外瘢痕黏连的实验研究

目的探讨局部应用他克莫司抑制成纤维细胞增殖、减少硬膜外瘢痕黏连的实验效果。方法 32只SD大鼠随机分为2组,行L1全椎板切除术后,暴露硬脊膜。治疗组(n=16)局部应用100μg/mL他克莫司,对照组(n=16)应用生理盐水。对手术前后大鼠行后肢运动功能评分(BBB评分)。术后4周行肉眼观察、组织学观察、硬膜外瘢痕面积测定及成纤维细胞计数。结果治疗组无明显硬膜外黏连,对照组形成致密的硬膜外黏连。治疗组瘢痕组织面积及成纤维细胞计数均低于对照组。所有实验动物无明显中毒症状,用药前后BBB评分差异无统计学意义。结论局部应用他克莫司可有效预防硬膜外黏连,且未见明显的不良反应。

Experimental study on prevention of epidural adhesion after laminectomy with topical tacrolimus

Objective To investigate the effect of topical Tacrolimus in preventing epidural adhesion after laminectomy.Methods Thirty-two SD rats were randomly divided into treatment group(n=16) and control group(n=16).Laminectomies were performed at L-1 in 32 rats.Cotton pads soaked with 100 μg/mL Tacrolimus was applied to the operative sites,with saline-treated laminectomy sites as controls.BBB scoring was detected before and after laminectomy.The rats were killed 4 weeks after surgery and were evaluated by macroscopic observation,histological evaluation,the epidural scar area and the fibroblast number after four weeks.Results No obvious adhesion formed in the Tacrolimus-treated group and severe epidural adhesion formed in the control group.The area of epidural fibrosis and the count of fibroblasts of the Tacrolimus-treated group showed significant decrease compared with the control group.Conclusion Topical application of Tacrolimus can prevent epidural adhesion after laminectomy,and no obvious toxic effects have been observed.