硬膜外瘢痕粘连防治的研究进展
摘要
椎板切除减压术是针对由椎骨骨折、后纵韧带骨化侵犯椎管、椎体病变等病因所致的椎管狭窄疾病的有效术式,而术后却常并发硬膜外瘢痕粘连,最终可致腰椎术后失败综合征。一旦并发症出现,药物、手术等治疗手段均收效甚微。目前主要的预防手段有药物预防、手术预防、局部材料阻隔预防及放射疗法预防,虽然预防方法种类繁多,但多因其潜在不良反应及方案自身无明确衡量标准而应用受限。临床中应根据患者的实际情况具体分析,选择最适合的疗法。
引文
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[23] Helm S,Hayek SM,Colson J,et al.Spinal endoscopic adhesiolysis in post lumbar surgery syndrome:an update of assessment of the evidence[J].Pain Physician,2013,16(Suppl 2 ):SE125-SE150.
[24] Gerszten PC,Moossy JJ,Flickinger JC,et al.Low-dose radiotherapy for the inhibition of peridural fibrosis after reexploratory nerve root decompression for postlaminectomy syndrome[J].J Neurosurg,2003,99(Suppl 3):271-277.
[2] Key JA,Ford LT.Experimental intervertebral-disc lesions[J].J Bone Joint Surg Am,1948,30A(3):621-630.
[3] LaRocca H,Macnab I.The laminectomy membrane.Studies in its evolution,characteristics,effects and prophylaxis in dogs[J].J Bone Joint Surg Br,1974,56B(3):545-550.
[4] Songer MN,Ghosh L,Spencer DL.Effects of sodium hyaluronate on peridural fibrosis after lumbar laminotomy and discectomy[J].Spine (Phila Pa 1976),1990,15(6):550-554.
[5] Zhu J,Li Y,Shen W,et al.Relationships between transforming growth factor-beta1,myostatin,and decorin:implications for skeletal muscle fibrosis[J].J Biol Chem,2007,282(35):25852-25863.
[6] Sun Y,Wang L,Sun S,et al.The effect of 10-hydroxycamptothecine in preventing fibroblast proliferation and epidural scar adhesion after laminectomy in rats[J].Eur J Pharmacol,2008,593(1-3):44-48.
[7] Liang Y,Sun Y,Li X,et al.The optimal concentration of topical hydroxycamptothecin in preventing intraarticular scar adhesion[J].Sci Rep,2014(4):4621.
[8] Dai J,Sun Y,Yan L,et al.Upregulation of NOXA by 10-Hydroxycamptothecin plays a key role in inducing fibroblasts apoptosis and reducing epidural fibrosis[J].Peer J,2017(5):e2858.
[9] 孙钰,冯新民,颜连启,等.羟基喜树碱预防硬膜外粘连的有效性和安全性研究[J].临床骨科杂志,2010,13(2):214-217.
[10] Yan L,Sun Y,Wang J,et al.The effect of mitomycin C in reducing intraarticular adhesion after knee surgery in rabbits[J].Eur J Pharmacol,2010,643(1):1-5.
[11] Sun Y,Ge Y,Fu Y,et al.Mitomycin C induces fibroblasts apoptosis and reduces epidural fibrosis by regulating miR-200b and its targeting of RhoE[J].Eur J Pharmacol,2015,765:198-208.
[12] Li X,Yan L,Wang J,et al.Comparison of the effects of mitomycin C and 10-hydroxycamptothecin on an experimental intraarticular adhesion model in rabbits[J].Eur J Pharmacol,2013,703(1-3):42-45.
[13] Paulo NM,de Brito e Silva MS,Moraes AM,et al.Use of chitosan membrane associated with polypropylene mesh to prevent peritoneal adhesion in rats[J].J Biomed Mater Res B Appl Biomater,2009,91(1):221-227.
[14] Nuseir AF,Alsalem M,Alzahr M,et al.The effect of topical 5-flurouracil application post endoscopic inferior turbinoplasty[J].Am J Otolaryngol,2017,38(2):135-138.
[15] Yan L,Li X,Wang J,et al.Immunomodulatory effectiveness of tacrolimus in preventing epidural scar adhesion after laminectomy in rat model[J].Eur J Pharmacol,2013,699(1-3):194-199.
[16] Sun Y,Zhao S,Li X,et al.Local application of rapamycin reduces epidural fibrosis after laminectomy via inhibiting fibroblast proliferation and prompting apoptosis[J].J Orthop Surg Res,2016,11(1):58.
[17] Darougheh A,Asilian A,Shariati F.Intralesional triamcinolone alone or in combination with 5-fluorouracil for the treatment of keloid and hypertrophic scars[J].Clin Exp Dermatol,2009,34(2):219-223.
[18] Wang Z,Wang Y,Xie P,et al.Calcium channel blockers in reduction of epidural fibrosis and dural adhesions in laminectomy rats[J].Eur J Orthop Surg Traumatol,2014,24(Suppl 1):S293-5298.
[19] 张晨阳,张岩,梁文锴.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[J].解放军医药杂志,2013,25(3):15-18.
[20] 雒永生,关永林,柳永明,等.当归注射液对椎板切除术后兔模型硬膜外瘢痕中PDGF表达的影响[J].中国中医骨伤科杂志,2015,23(4):1-4.
[21] 魏凌平,冯利刚,刘莹菁.川芎嗪聚乙稀醇膜预防椎板切除术后硬膜外粘连的有效性分析[J].中外医学研究,2013,11(22):42-43.
[22] 周曙,何秀芝,薛潇春,等.姜黄素诱导增生性瘢痕成纤维细胞凋亡机制研究[J].辽宁中医药大学学报,2016,18(1):38-41.
[23] Helm S,Hayek SM,Colson J,et al.Spinal endoscopic adhesiolysis in post lumbar surgery syndrome:an update of assessment of the evidence[J].Pain Physician,2013,16(Suppl 2 ):SE125-SE150.
[24] Gerszten PC,Moossy JJ,Flickinger JC,et al.Low-dose radiotherapy for the inhibition of peridural fibrosis after reexploratory nerve root decompression for postlaminectomy syndrome[J].J Neurosurg,2003,99(Suppl 3):271-277.