胶原酶用于预防椎板切除术后硬膜外粘连的实验研究

An experimental study of collagenase on prevention of peridural adhesion after laminectomy

目的 :通过动物实验观察预防椎板切除术后硬膜外粘连的有效材料和方法。方法 :家兔 90只 ,随机分为 3组。无菌术下用微型咬骨钳咬除其腰段椎板 ,造成 0 5cm× 2 5cm椎板缺损 ,保留完整硬膜 ,彻底止血后选择 3种不同处理。A组椎板缺损区充填生理盐水 0 5ml;B组椎板缺损区充填透明质酸钠 0 5ml;C组椎板缺损区充填胶原酶 0 5ml(1 2 0单位 )。麻醉苏醒后在同一饲养条件下分笼饲养 ,并于 2、4、8、1 2周随机选取动物进行肉眼观察、光镜观察和统计学分析。结果 :按改良Nussbaum组织学评分 :2、4、8、1 2周C组积分最低 ,粘连程度最轻 ,C组与A组、C组与B组在各时间点比较差异均显著 (P <0 0 5) ;B组 2、4周时积分较低 ,与A组比较差异显著 (P <0 0 5) ,8、1 2周与A组无显著差异 (P >0 0 5)。结论 :胶原酶可以预防椎板切除术后硬膜和神经根周围的粘连 ;而且其作用优于目前认为效果较好的透明质酸钠。

Objective:To find out effective materials and methods for the prevention of peridural adhesion after laminectomy by experimental study.Methods:90 rabbits are divided into 3 groups at random.Lumber vertedeal plate were excised with rongeur under sterlity.The dural must not be injured.We choosed 3 different methods.Group A:filled with 0.9% natrium choride.Group B:filled with sodium hyaluronate and group C:collagenase was used.After waken up,the rabbits were feeded alone under the same condition and examed in 2、4、8、12 weeks at random and observated by eyes,light microscopy and statistical management.Results:Histological score according to modified Nussbaum measurement:the score of group C is the lowest at 2、4、8、12 weeks.There is not significant differnce between group B and group A,except at 2 weeks.Conclusions:Collagenase can prevent peridural and nerve root adhesion after laminectomy;its effects is superior to sodium hyaluronate.