7.0T Micro MRI观察丝裂霉素C预防硬膜外粘连的效果研究

Experimental study on prevention of peridural adhesion with topical mitomycin C by 7.0T Micro MRI

目的:应用7.0T Micro MRI探讨预防椎板切除后硬膜外粘连实验研究中丝裂霉素C(MMC)的理想浓度及其使用安全性。方法:30只SD大鼠随机分成5组,每组6只。分别切除L1椎板,术中各组分别以棉片浸透生理盐水(A组)或0.1mg/ml(B组)、0.3mg/ml(C组)、0.5mg/ml(D组)、0.7mg/ml(E组)的MMC,置于裸露的硬脊膜后5min。应用MMC前后分别对大鼠行体感诱发电位测定。术后4周处死大鼠取手术段脊柱,分别做MicroMRI扫描、瘢痕组织面积测定、肉眼观察硬脊膜与后方瘢痕组织粘连情况。结果:A组标本硬膜外瘢痕组织致密,瘢痕面积大,与硬脊膜形成紧密粘连。B组和C组标本硬膜外瘢痕组织不致密,瘢痕面积减小,与硬脊膜部分粘连。D组和E组标本硬膜外瘢痕组织不致密,瘢痕面积更小,与硬脊膜未形成明显粘连。大鼠应用MMC前后体感诱发电位无明显改变。结论:局部应用浓度为0.5mg/ml的MMC能有效减少硬膜外瘢痕组织增生,避免椎板切除术后硬膜外瘢痕粘连,并且安全。0.5mg/ml浓度的MMC可能是椎板切除后预防硬膜外粘连理想的浓度选择。

Objective：To study the suitable concentration and the security of topical mitomycin C （MMC） in preventing postlamineetomy peridural adhesion by 7.0T Miero MRI. Methods：Lamineetomies were performed at LI in 30 rats. Cotton pads soaked either with 0.1 mg/ml（group B）,0.3 mg/ml （group C）,0.5 mg/ml （group D）,0.7 mg/ml（group E） MMC,or saline（group A） were applied to the operative sites for five minutes. To determine the somatosensorv evoked potential （SEP）, the rats were killed 4 weeks after surgey. The specimens were prepared for determination of the degree of sear adhesion according to Rydell method and the area of the sear with MRI. Results No obvious adhesion were found in group D and group E. Severe peridural adhesion were formed in the control group （group A）. The area of the scar with Miero MRI in group D and E showed significant decrease. The SEP did not alter obviously. Conclusion0.5 mg/ml MMC mav be suitable concentration in preventing postlaminectomy peridural adhesion.