局部应用丝裂霉素C预防椎板切除术后硬膜外粘连的实验研究

Experimental study on prevention of peridural adhesion after laminectomy with topical mitomycin C

目的:探讨局部应用丝裂霉素C(mitomycinC,MMC)预防椎板切除术后硬膜外粘连的效果。方法:手术切除12只SD大鼠第一腰椎椎板,造成0.2cm×0.5cm硬脊膜裸露区,随机分为2组,每组6只。实验组以棉片浸透0.1mg/mlMMC,对照组以棉片浸透生理盐水置于裸露的硬脊膜后5min。术后第4周处死动物,测定其硬膜外组织中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:实验组无明显硬膜外粘连,对照组形成致密的硬膜外粘连。实验组胶原面积及成纤维细胞记数较对照组明显降低。结论:局部应用MMC可有效预防椎板切除术后硬膜外粘连的形成。

Objective： To study the effectiveness of topical mitomycin C in preventing postlaminectomy peridural Adhesion. Methods： Laminectomies were performed at L-1 in 12 rats. Cotton pads soaked either with 0.01mg/ml mitomycin C or saline were applied to the operative sites, with saline-treated laminectomy sites as controls. The rats were killed 4 weeks after surgery. The specimens were prepared for determination of the degree of scar adhesion according to Rydell method, the area of peridural fibrosis and the count of fibroblasts. Results： No obvious adhesion formed in the experiment group,severe peridural adhesion were formed in control group. The area of peridural fibrosis and the count of fibroblasts of the mitomycin C-treated rats showed significant decrease. Conclusion ： Topical application of mitomycin C may be a successful method of preventing postlaminectomy peridural fibrosis.