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实验研究

Empirical Study of Salvia Miltiorrhizae Hyaluronic Acid Gel Mixture in Prevention of Epidural Adhesions after Laminectomy in Rabbits

目的评估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效果。方法将腰5全椎板切除的新西兰兔36只随机分为3组,A组:术区生理盐水冲洗后关闭切口,B组和C组:分别在暴露出的硬膜外覆盖透明质酸和丹参透明质酸凝胶混合物后关闭切口。所有动物术后6周行安乐死,完整切下脊柱节段(腰4～6)进行如下观察:①对硬膜外粘连程度进行大体观察;②对标本进行组织学观察和评估;③取术区硬膜外背侧少量瘢痕组织行羟脯氨酸浓度分析。结果大体观察发现,A组硬膜外粘连程度最重,高于B组和C组(P<0.05),B组粘连程度高于C组(P<0.05);组织学观察结果与大体观察结果一致;C组瘢痕组织中羟脯氨酸浓度明显低于B组(P<0.05)和A组(P<0.05)。结论丹参透明质酸凝胶混合物能在术后6周有效预防兔椎板切除术后硬膜外粘连的发生。

Objective To evaluate the effectiveness of Salvia Miltiorrhizae Hyaluronic acid gel mixture in prevention of epidural adhesions after laminectomy in rabbits.Methods Thirty-six New Zealand rabbits with lumbar laminectomy at L5 were randomly divided into three groups： group A was flushed incision with physiological saline before wound closure,while group B and C were covered with Hyaluronic acid gel or Salvia Miltiorrhizae Hyaluronic acid gel mixture on the exposed dura respectively before wound closure.All animals underwent euthanasia at post-surgery 6 weeks,and the spinal sections（L4-L6） were removed inextenso and were observed as follows： the epidural adhesion degree was observed by macroscopic observation;the histological observation and evaluation of the specimen were performed;the hydroxyproline concentration analysis of scar tissue in the backside of the epidural mater was performed.Results Epidural adhesions degree in group A was more severely than those in group B and group C by macroscopic evaluation（P 0.05）,while the epidural adhesions degree in group B was more severely than that in group C（P 0.05）;the result of histological observation was the same with that of macroscopic evaluation;the hydroxyproline concentration of scar tissue in group C was significantly lower than those in group B（P 0.05） and group A（P 0.05）.Conclusion Salvia Miltiorrhizae Hyaluronic acid gel mixture can effectively prevent the epidural adhesions after laminectomy in rabbits at post-surgery 6 weeks.