丹参透明质酸凝胶混合物预防兔椎板切除术后硬膜外粘连的安全性研究

Security Study of Salvia Miltiorrhizae Hyaluronic Acid Gel Mixture in Prevention of Epidural Adhesions after Rabbit's Laminectomy

目的探讨丹参透明质酸凝胶混合物预防兔椎板切除术后硬膜外粘连的安全性。方法将腰5全椎板切除的新西兰兔24只随机分为4组,A组为对照组:术区生理盐水冲洗后关闭切口,B、C、D组均为实验组:均在术区覆盖丹参透明质酸凝胶混合物,剂量分别为0.5、0.75、1.0 ml。分别于麻醉后、椎板切除术后、关闭手术切口后、术后6周4个时点进行体感诱发电位(CSEP)监测并记录潜伏期值,并分别于术前、术后第1天、术后6周对各组动物进行后肢运动功能评分。结果关闭手术切口后测定各组CSEP潜伏期值显示:A、B组潜伏期值均无延迟(P>0.05),C、D组潜伏期值出现明显延迟(P<0.05)。在术后6周复测,各组潜伏期值均回归正常范围(P>0.05)。运动功能评分结果:术后第1天,A、B组评分正常,C、D组评分下降;术后6周,各组运动功能评分均正常。结论 0.5 ml的丹参透明质酸凝胶混合物不会对兔椎板切除术后脊髓的电生理功能及后肢运动功能产生影响,术中应用可预防术后硬膜外粘连。

Objective To investigate the safety of salvia mittiorrhizae hyaluronic acid gel mixture in prevention of epidural adhesions after laminectomy. Methods Twenty-four New Zealand white rabbits with lumbar laminectomy at fifth lumbar vertebra （ L5 ） were randomly divided into four groups ： in group A only physiological saline was used to flush incision before wound closure, while in the therapy group B, C and D the exposed dura were covered with 0.5, 0.75 and 1.0 ml of salvia mihiorrhizae hyaluronic acid gel mixture respectively before wound closure. The Cortical somatosensory evoked potential CSEP and latency were monitored and recorded after anesthesia, laminectomy, wound closure and at postoperative 6 weeks respectively. Hindlimb motor function scoring was preformed at the time of preoperative and postop- erative 1 day and 6 weeks after operation. Results There was no prolongation in CSEP latency in group A and B （ P 〉 0.05 ） , while the latency in group C and D was significantly prolonged （ P 〈 0.05 ）. At 6 weeks after operation the laten- cy in all groups were all in the normal range （P 〉 0.05 ）. The evaluation of motor function scores revealed that there were a normal motor functions at postoperative 1 d in group A and B and descent in group C and D ; the nmtor functions scores of all groups were normal 6 weeks after operation. Conclusion The application of 0.5 ml salvia miltiorrhizae hyaluronic acid gel mixture will not affect the electrophysiological function of spine and motor function of animal models, and intraop- erative application can prevent postoperative epidural adhesions.