不同浓度丝裂霉素C预防椎板切除术后硬膜外黏连的实验研究

目的]比较局部应用不同浓度丝裂霉素C(MMC)预防椎板切除术后硬膜外黏连的效果。方法]40只SD大鼠随机分为4组,分别切除L1椎板。术中各组分别以棉片浸透生理盐水(C组)、0.01 mg/m l(L组)、0.05mg/m l(M组)、0.1 mg/m l(H组)MMC,置于裸露的硬脊膜后5 m in。术后第4周处死动物取材,分别作肉眼观察、羟脯氨酸(HOP)含量测定、胶原组织面积测定及成纤维细胞记数。结果]C组标本硬膜外瘢痕组织致密,与硬脊膜形成紧密黏连。H组无明显硬膜外黏连,HOP含量、胶原组织面积及成纤维细胞记数显著减少。M、L组HOP含量、胶原组织面积及成纤维细胞记数不同程度的减少,但不能避免硬膜外黏连的形成。结论]局部应用浓度为0.1mg/m l的MMC能够有效减少硬膜外瘢痕组织增生,避免椎板切除术后硬膜外瘢痕黏连。

Experimental study on prevention of peridural adhesion after laminectomy with local different concentration mitomycin C

Objective]To compare the effects of topical different concentration mitomycin C(MMC)in preventing postlaminectomy peridural adhesion.Method]Laminectomies were performed at L1 in 40 rats.Cotton pads soaked either with 0.01 mg / ml(group L),0.05 mg /ml(group M),0.1 mg / ml(group H) MMC or saline(group C) were applied to the operative sites.The rats were killed 4 weeks after surgery.The specimens were prepared for determination of the degree of scar adhesion according to Rydell method,the content of Hydroxyproline(HOP),the area of peridural fibrosis and the count of fibroblasts.Result]Dense peridural fibrosis with marked peridural adhesion showed in group C.No obvious adhesion formed in group H.In group M and L,peridural adhesion wasn't avoided.The content of HOP,the area of peridural fibrosis and the count of fibroblasts showed various degrees decrease in all MMC-treated groups.Conclusion]Local application of 0.1 mg/ ml MMC may be a successful method of reducing postlaminectomy peridural fibrosis and completely avoided peridural adhesion.