丹参凝胶对椎板切除术后硬膜外粘连的影响  

Effect of SMB-gel on peridural adhension after laminectomy

作　　者：陈蓟 肖德明 杨宏图 吕猛 林博文 镇万新 

机构地区：[1]深圳市人民医院暨南大学第二临床学院骨关节科,518020

出　　处：《中华实验外科杂志》2006年第4期609-610,共2页Chinese Journal of Experimental Surgery

基　　金：深圳市科技基金资助项目(200104066)

摘　　要：目的通过动物实验观察超微结构研究预防椎板切除术后硬膜外粘连的有效材料和方法。方法取卡波姆(Carborner)与丹参(SMB),制成凝胶、丹参凝胶。36只大白兔随机分为4 组;切除L3、L6椎板后造成10 mm×5 mm椎板缺损区。A组:空白对照组;B组:凝胶对照组;C 组:透明质酸钠(HA)组;D组:丹参凝胶组。术后4周时标本进行透射电镜观察,4、6、8周L3、L6 两节段标本进行瘢痕厚度的计算机图像分析。结果瘢痕厚度A、B、C组与D组有明显差异。F 值分别为128．657、152．246、80．891;电镜观察:A、B、C组均可见增殖活跃的成纤维细胞,D组成纤维细胞增值不活跃。结论丹参凝胶具有良好的预防椎板切除术后硬膜外粘连的作用,丹参可抑制成纤维细胞增生。Objective To find out the effective materials and methods for the prevention of peridural adhension after laminectomy. Methods The gel and salviamiltriorrhiza （SMB） gel were acquired from the Carbomer and SMB. Laminectomy was performed in L3, L6 on 36 rabbits which had been divided into 4 groups randomly, and resulted in the status of 10 mm × 5 mm lamina defect. Different treatments were applied on the 4 groups： group A （blank control）, group B （get treated）, group C （2 % sodium hyaluronate treated）, and group D （SMB-gel treated）. One specimen of each group was examined under electron transmission microscopy at the 4th postoperative week. Computed imaging analysis of epidural adhension of each group was also done at the 4th, 6th, and 8th postoperative week. Results At each time, there was statistical difference in the thickness of the adhension between group A, B, C and group D with F values being 128. 657,152. 246, 80. 891 respectively. The proliferating fibroblasts could be observed by microscopy at 4th postoperative week in groups A, B and C, while in group D, the proliferation was inactive. Conclusion SMB-gel has been proved to have the best effect in preventing peridural adhesion after laminectomy. SMB can inhibit the fibroblasts from proliferation.

关 键 词：丹参 椎板切除术 粘连 预防 

分 类 号：R285.5[医药卫生—中药学]