川芎嗪与自体骨膜联合运用预防椎板切除术后硬膜外粘连的实验研究

目的 观察椎板切除术后用川芎嗪的同时在椎板缺损处植入自体骨膜预防硬膜外粘连的效果.方法 48只SD大鼠随机分成4组(n=12),均制作L2椎板损伤模型,A组硬膜外涂布生理盐水,B组硬膜外涂布川芎嗪,C组硬膜外覆盖自体骨膜,D组硬膜外涂布川芎嗪的同时加自体骨膜覆盖.术后12周对4组椎板切除部位进行大体观察,对粘连度、胶原含量、组织学评分及骨转化生长因子定量分析进行比较.结果 B、C、D组的改良RydellBalazs粘连韧度评分、胶原含量、改良Nussvuaum组织学评分均优于A组,差异有统计学意义(P<0.05),D组优于B、C组,差异均有统计学意义(P<0.05);TGF-β灰度值C组与D组高于A组与B组,差异均有统计学意义(P<0.05).结论 联合运用川芎嗪和自体骨膜能有效预防硬膜外瘢痕粘连和形成,比单独应用川芎嗪和(或)自体骨膜预防效果好.

Tetramethylpyrazine and autogenous periosteum to prevent peridural fibrosis and adhesion after laminectomy

Objective To study the effect of Tetramethylpyrazine plus autogenous periosteum on prevention of fibrous scar formation in the epidural space after laminectomy. Methods Forty-eight SD rats were divided randomly into 4 groups.Laminectomy was performed in the segment of lumbar 2.The exposed dura was covered with saline solution (group A),Tetramethyipyrazine(group B),autogenous periostoum(group C)and Tetramethylpyrazine plus autogenous periosteum(group D)respectively.12 weeks postoperatively,evaluation wag based on the gross and histopathological observations,biochemical examination,and bone aiming factor quantitative analysis.Results In modified RydellBalazs score for adhesion toughness,collagen content and modified Nussvuanm score for histology,groups B,C and D were significantly superior to group A(P<0.05)while group D wag significantly superior to groups B and C (P<0.05).TGF-β values in groups C and D were significantly higher than those in groups A and B(P<0.05). Conclusion The combined application of Tetramethylpyrazine plus autogenous periosteum has a better effect on prevention of peridural adhesion after laminectomy than application of just either of the two.