曲安奈德治疗兔腰椎术后硬膜外粘连的疗效  

Efficacy of triamcinolone acetonide in treating epidural adhesion after lumbar spine surgery in rabbits

作　　者：袁赤亭[1] 洪盾[1] 章礼炜 范勇勇 YUAN Chiting;HONG Dun;ZHANG Liwei(Department of Orthopedics,Taizhou Hospital of Zhejiang,Linhai 317000,CHINA)

机构地区：[1]浙江省台州医院骨科,浙江临海317000

出　　处：《江苏医药》2020年第12期1198-1201,F0002,共5页Jiangsu Medical Journal

基　　金：浙江省医药卫生科技计划(2021KY1197、2015KYB443)。

摘　　要：目的探讨曲安奈德治疗兔腰椎术后硬膜外粘连的疗效。方法72只雄性大白兔建立兔腰椎硬膜外粘连模型,分别将曲安奈德5 mg+明胶海绵(A组,28只)、0.9%生理盐水0.5 mL+明胶海绵(B组,28只)、明胶海绵(C组,16只)填充于硬膜外露口。1个月后,检测兔后肢运动功能、硬膜外粘连程度、骨小梁和椎旁肌的变化以及IL-6、TGF-β1 mRNA在硬膜外瘢痕组织中的表达。结果三组兔运动功能评分无统计学差异(P>0.05)。与B组和C组相比,A组硬膜外粘连较轻,炎症细胞数量较少,硬膜外瘢痕组织IL-6和TGF-β1 mRNA表达较少(P<0.05),而B组和C组之间各指标无统计学差异(P>0.05)。三组骨小梁面积和宽度以及椎旁肌细胞数量和大小无统计学差异(P>0.05)。结论曲安奈德可以减轻兔腰椎术后硬膜外粘连程度及炎症反应,对周围骨小梁和椎旁肌无明显影响。Objective To investigate the efficacy of triamcinolone acetonide in the treatment of epidural adhesion after lumbar spine surgery in rabbits.Methods The model of epidural adhesion in rabbit lumbar spine was established in 72 male rabbits.The epidural exposure was filled with triamcinolone acetonide 5 mg plus gelfoam(group A,28 cases),0.9%normal saline 0.5 mL plus gelfoam(group B,28 cases)or gelfoam(group C,16 cases).One month later,the motor function of rabbit hind limbs,epidural adhesion,changes of bone trabecula and paravertebral muscle and mRNA expressions of IL-6 and TGF-β1 in epidural scar tissues were detected.Results The motor function score of rabbit hind limbs was not different among the three groups(P>0.05).Compared to groups of B and C,the epidural adhesion was mild in group A,the number of inflammatory cells was less and the mRNA expressions of IL-6 and TGF-β1 were lower(P<0.05),which were not different between groups of B and C(P>0.05).The area and width of bone trabecula and number and size of paravertebral muscle cells were not significantly different among the three groups(P>0.05).Conclusion Triamcinolone acetonide can alleviate the degree of epidural adhesion and inflammatory reaction after lumbar spine surgery in rabbits and has no significant effect on the bone trabecula and paravertebral muscle.

关 键 词：曲安奈德 硬膜外粘连 腰椎 

分 类 号：R687[医药卫生—骨科学]