目的 探讨局部应用他克莫司抑制成纤维细胞增殖、减少硬膜外瘢痕黏连的实验效果.方法 32只SD大鼠随机分为2组,行L1全椎板切除术后,暴露硬脊膜.治疗组(n=16)局部应用100 μg/mL他克莫司,对照组(n=16)应用生理盐水.对手术前后大鼠行后肢运动功能评分(BBB评分).术后4周行肉眼观察、组织学观察、硬膜外瘢痕面积测定及成纤维细胞计数.结果 治疗组无明显硬膜外黏连,对照组形成致密的硬膜外黏连.治疗组瘢痕组织面积及成纤维细胞计数均低于对照组.所有实验动物无明显中毒症状,用药前后BBB评分差异无统计学意义.结论 局部应用他克莫司可有效预防硬膜外黏连,且未见明显的不良反应.%Objective To investigate the effect of topical Tacrolimus in preventing epidural adhesion after laminectomy. Methods Thirty - two SD rats were randomly divided into treatment group ( n = 16) and control group ( n = 16). Laminectomies were performed at L - 1 in 32 rats. Cotton pads soaked with 100 |j,g/mL Tacrolimus was applied to the operative sites, with saline -treated laminectomy sites as controls. BBB scoring was detected before and after laminectomy. The rats were killed 4 weeks after surgery and were evaluated by macroscopic observation, histological evaluation, the epidural scar area and the fibroblast number after four weeks. Results No obvious adhesion formed in the Tacrolimus - treated group and severe epidural adhesion formed in the control group. The area of epidural fibrosis and the count of fibroblasts of the Tacrolimus - treated group showed significant decrease compared with the control group. Conclusion Topical application of Tacrolimus can prevent epidural adhesion after laminectomy, and no obvious toxic effects have been observed.
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