丝裂霉素C和5-氟尿嘧啶预防椎板切除术后硬膜外瘢痕粘连的效果比较  

Effectiveness of topical mitomycin C or 5-Fiuorouracil in preventing peridural adhesion after laminectomy

作　　者：曹晓建[1] 张宁[1] 金正帅[1] 王立新[1] 

机构地区：[1]南京医科大学第一附属医院骨科,210029

出　　处：《中华实验外科杂志》2006年第6期731-733,共3页Chinese Journal of Experimental Surgery

摘　　要：目的比较局部应用丝裂霉素C(MMC)和5-氟尿嘧啶(5-Fu)预防椎板切除术后硬膜外粘连的效果。方法手术切除30只SD大鼠第1腰椎椎板,造成0．2 cm×0．5 cm硬脊膜裸露区,随机分为3组,每组10只。MMC组以棉片浸透0．1 g/L MMC,5-Fu组以棉片浸透25 g/L 5- Fu,对照组以棉片浸透生理盐水置于裸露的硬脊膜后5 min。术后第4周处死动物,测定其硬膜外组织中羟脯氨酸的含量、胶原组织面积及成纤维细胞记数,同时根据Rydell分级标准评价粘连程度。结果MMC组无明显硬膜外粘连,5-Fu组和对照组均形成紧密的硬膜外粘连。MMC组羟脯氨酸的含量、胶原组织面积及成纤维细胞记数较5-Fu组和对照组明显降低。而5-Fu组与对照组无明显差异。结论局部应用丝裂霉素C可有效预防椎板切除术后硬膜外粘连的形成,而5-Fu无明显效果。Objective To compare the effectiveness of topical mitomycin C （MMC） or 5-Fluorouracil （5-Fu） in preventing postlaminectomy peridural adhesion. Methods Laminectomies were performed at L-1 on 30 rats. Cotton pads soaked with 0.1 g/L MMC or 25 g/L 5-Fu or saline were applied to the operative sites. The rats were killed 4 weeks after surgery. The specimens were prepared for deterrat＇nation of the degree of scar adhesion according to Rydell method, the content of hydroxyproline and area of peridural fibrosis and the count of fibroblasts. Results No obvious adhesion was formed in MMC group, while severe peridural adhesion was formed in 5-Fu group and control group. The content of hydroxyproline, the area of peridural fibrosis and the count of fibroblasts in the MMC-treated rats were significantly decreased. Conclusion Topical application of MMC rather than 5-Fu may be a successful method of preventing postlaminectomy peridural fibrosis.

关 键 词：椎板切除术 硬膜 粘连 丝裂霉素C 5-氟尿嘧啶 

分 类 号：R687[医药卫生—骨科学]