汉防己甲素预防椎板切除术后硬膜外粘连  

Preventive effect of tetrandrine on extradural adhesion after laminectomy

作　　者：田晓滨[1] 张一[1] 罗春山[1] 胡如印[1] 汪雷[1] 

机构地区：[1]贵州省人民医院骨科,贵州省贵阳市550002

出　　处：《中国临床康复》2006年第47期35-38,共4页Chinese Journal of Clinical Rehabilitation

基　　金：贵州省省长专项基金[黔专合字(2005)27号]~~

摘　　要：目的:观察汉防己甲素对预防椎板切除术后硬膜周围瘢痕粘连的作用。方法:实验于2005-08/10在贵阳医学院动物实验中心完成动物实验,光镜观察完成于贵州省人民医院病理科,电镜观察在贵州师范大学电镜中心完成。①30g/L汉防己甲素制备:用0.1mol/L的HCl30mL将3.0g980g/L汉防己甲素(杭州中香化学有限公司)充分溶解,再以0.1mol/L的NaOH反滴定至pH值5.5,最后以生理盐水(pH=5.5)定容至100mL,4℃保存备用。②40只成年大白兔采用随机数字法分为4组,每组10只。将兔行L3节段椎板切除术,形成一处10mm×5mm的硬脊膜裸露区。生理盐水组:予0.5mL生理盐水覆盖;明胶海绵组:予明胶海绵覆盖;汉防己甲素组:予0.5mL汉防己甲素覆盖;汉防己甲素+明胶海绵组:予浸湿汉防己甲素的明胶海绵覆盖。③术后2,4,8周取材作大体、光镜、透射电镜观察;8周行硬膜外粘连分级及计算机图像分析。结果:40只大白兔全部进入结果分析。①瘢痕生长情况:大体、光镜、电镜观察生理盐水组及明胶海绵组硬膜外瘢痕粘连日趋明显。汉防己甲素组及汉防己甲素+明胶海绵组炎性细胞渗出较少,成纤维细胞较少,胶原纤维形成较少,硬膜外瘢痕无粘连。②瘢痕面积和粘连长度/硬膜周长比值测定:生理盐水组两项指标均大于汉防己甲素组、汉防己甲素+明胶海绵组[(0.237±0.004),(0.087±0.004),(0.099±0.006)mm2;0.201±0.006,0.059±0.024,0.063±0.008;P<0.01];明胶海绵组上述两指标也大于汉防己甲素组、汉防己甲素+明胶海绵组(P<0.01);而生理盐水组和明胶海绵组,汉防己甲素组和汉防己甲素+明胶海绵组间则差异无显著性(P>0.05)。结论:汉防己甲素可以有效地预防椎板切除术后硬膜外瘢痕粘连的形成。AIM： To observe the preventive effect of tetrandrine （Tet） on the cicatricial adhesions around dura mater after laminectomy. METHODS： From August to October 2005, the experiment was conducted at the Animal Experimental Center of Guiyang Medical College, and the light microscope observation was performed in the Department of Pathology, Guizhou Provincial People＇s Hospital, while the electronic microscope observation was carried out in the Electronic Microscope Center of Guizhou Normal University.①Preparation of Tet （30 g/L）： 3.0 g Tet （980 g/L, made by China Aroma Chemical CO., Ltd. Hangzhou） was dissolved with 30 mL HCL （0.1 mol/L） and back titrated with 0.1 mol/L NaOH till pH=5.5. Finally the normal saline （pH=5.5） was added to fix the cubage to 100 mL. which was preserved at 4℃. ②Forty adult rabbits were randomly divided into 4 groups with 10 rabbits in each group. The rabbits were subjected to G-segment laminectomy to form a 10 mm×5 mm open area of the dura mater of spinal cord. Then the normal saline group was covered by 0.5 mL normal saline; gelatin sponge group by gelatin sponge; Tet group by 0.5 mL Tet; Tet plus gelatin sponge group by gelatin sponge soaked with Tet. ③The samples taken at 2, 4, 8 weeks after operation were observed with eyes, optical microscope and transmission electronic microscope. At the eighth week, the extradural adhesion grading and computer image analysis were performed. RESULTS： All the 40 rabbits were involved in the result analysis. ① Growth condition of cicatrice： The observation with eyes, optical microscope and transmission electronic microscope showed that the cicatricial adhesions became gradually obvious in the saline and gelatin sponge groups. There were less inflammatory exudation, fibroblasts, and collagenous fibers and no extradural cicatricial adhesions were found in Tet and Tet plus gelatin sponge groups. ②Measurement of the scar area （SA） and the dura mater adhesion length （DAL）/dura mater perimeter （DP）： SA

关 键 词：粉防己碱 椎板切除术 成纤维细胞 瘢痕 

分 类 号：R285[医药卫生—中药学]