当归注射液预防椎板切除术后硬膜外粘连的实验研究  

Clinical Study on Angelica Parenteral Injection in Preventing Epidural Adhesion after Laminectomy

作　　者：杨利学[1] 邵松涛[2] 王官林[2] 李智斌[1] 

机构地区：[1]陕西中医学院附属医院,陕西咸阳712083 [2]陕西中医学院

出　　处：《中国中医骨伤科杂志》2013年第4期4-7,共4页Chinese Journal of Traditional Medical Traumatology & Orthopedics

基　　金：咸阳市科学技术研究项目(项目编号2010k14-02);陕西省教育厅科学研究项目(项目编号2010JK509);陕西省教育厅重点学科及国家中医管理局重点建设专科专项基金资助

摘　　要：目的:观察和评价硬膜外滴注当归注射液对椎板切除模型动物硬膜外瘢痕形成及硬膜粘连的干预作用效果,并探讨其作用机制。方法:48只新西兰兔随机分为A、B、C、D组,每组12只。手术切除L3椎板造成5mm×5mm硬脊膜裸露区。A组:椎板缺损区不做任何处理,直接缝合伤口;B组:仔细剪取与椎板缺损区相应大小的明胶海绵轻轻置于椎板缺损区硬膜外并滴入1mL生理盐水;C组:仔细剪取与硬膜显露区相应大小的明胶海绵轻轻置于显露区硬膜外并均匀涂布玻璃酸钠0.1mL;D组:仔细剪取与硬脊膜裸露区相应大小的明胶海绵轻轻置于显露区硬膜外并滴注1mL当归注射液;分别于术后2周、4周、6周分3批处死动物,切取手术段脊柱进行大体观察,组织学观察并进行碱性成纤维细胞因子(basic fibroblast growth factor,bFGF)及羟脯氨酸(hydroxyproline,HYP)含量的测定。结果:当归注射液组硬膜外瘢痕形成较空白组和模型组少,创伤后炎症反应轻,瘢痕组织中bFGF含量及HYP含量较空白组和模型组低,随着时间的延长,当归注射液组瘢痕组织中bFGF含量和HYP含量较玻璃酸钠组高,呈现显著性差异。结论:4周内当归注射液可减轻硬膜外瘢痕粘连,而随着时间延长,当归注射液预防椎板切除术后硬膜外瘢痕形成及硬膜粘连的作用较玻璃酸钠无明显优势。Objective：To observe and evaluate the interventive effect of angelica parenteral injection on epidural cicatrization and adhesion after laminectomy, and to detect its mechanism. Methods.. All 48 New Zealand rabbits were randomly divided into A, B, C, and D groups （n=12）. The 5mm × 5mm epidural area was exposed after L3 laminectomy. The laminectomy defect area of group A received no treatment and the wounds were directly sutured. The corresponding size of gelatin sponge were gently placed in the epidural of the laminectomy defect district in group B, C, and D, and the district were dripped with 1 ml saline, 0.1 ml sodium hyaluronate, and 1 ml angelica parenteral injection respectively. The rabbits were killed and surgery district spines were cut to histological observe, and the levels of basic fibroblast growth factor （bFGF） and hydroxyproline （Hyp） were measured in three tranches at 2, 4 and 6 weeks after surgery. Results：The epidural cicatri- zation and inflammatory response, and the levels of bFGF and Hyp in the group D were less than group A and group B. The levels of bFGF and Hyp of scar tissue in group D were higher than group C （P^O. 05）. Conclusions：Angelica parenteral injection can prevent epidural adhesion at the first 4 weeks, and have no obvious advantage in preventing epidural scar formation and subdural adhesions compared with sodium hyaluronate as time goes on.

关 键 词：椎板切除术 FBSS 硬膜外瘢痕 当归注射液 碱性成纤维细胞因子 羟脯氨酸 

分 类 号：R-33[医药卫生]