CAJ | 학술논문

背景:研究已证实人工脊柱膜预防腰椎手术后瘢痕形成具有很好的临床效果,但是否可以减少腰椎手术后炎症因子释放目前还不明确.目的:探讨人工硬脊膜对腰椎术后血液及引流液中炎症因子质量浓度的影响.方法:选择2012年3至7月北京军区总医院全军创伤骨科研究所收治的40例腰椎间盘突出伴腰椎管狭窄患者,均行腰椎后路减压、椎间盘摘除、椎间植骨融合内固定;按抽签方法随机分为2组,使用人工硬脊膜者为试验组,未使用人工脊柱膜者为对照组,另纳入10名健康志愿者为空白对照组.检测3组手术前、手术后第2,3天血液标本白细胞介素1β、白细胞介素6及肿瘤坏死因子α的质量浓度;采用酶联免疫吸附实验检测试验组、对照组术后第1,2,3天引流液中白细胞介素1β、白细胞介素6及肿瘤坏死因子α的质量浓度.结果与结论:①引流液:试验组手术后不同时间点3种炎症因子水平均显著低于对照组(P <0.05),且试验组患者未发现发热、过敏、异物排斥等不良反应,引流量明显少于对照组(P <0.05).②血液:试验组术后第3天白细胞介素1β、肿瘤坏死因子α的质量浓度明显低于对照组(P <0.05),两组各时间点白细胞介素1β、白细胞介素6、肿瘤坏死因子α质量浓度均明显高于空白对照组(P <0.05).表明应用人工硬脊膜可以降低腰椎术后引流液中白细胞介素1β、白细胞介素6、肿瘤坏死因子α的质量浓度,同时对外周血炎症因子质量浓度有轻度降低作用.
배경:연구이증실인공척주막예방요추수술후반흔형성구유흔호적림상효과,단시부가이감소요추수술후염증인자석방목전환불명학.목적:탐토인공경척막대요추술후혈액급인류액중염증인자질량농도적영향.방법:선택2012년3지7월북경군구총의원전군창상골과연구소수치적40례요추간반돌출반요추관협착환자,균행요추후로감압、추간반적제、추간식골융합내고정;안추첨방법수궤분위2조,사용인공경척막자위시험조,미사용인공척주막자위대조조,령납입10명건강지원자위공백대조조.검측3조수술전、수술후제2,3천혈액표본백세포개소1β、백세포개소6급종류배사인자α적질량농도;채용매련면역흡부실험검측시험조、대조조술후제1,2,3천인류액중백세포개소1β、백세포개소6급종류배사인자α적질량농도.결과여결론:①인류액:시험조수술후불동시간점3충염증인자수평균현저저우대조조(P <0.05),차시험조환자미발현발열、과민、이물배척등불량반응,인류량명현소우대조조(P <0.05).②혈액:시험조술후제3천백세포개소1β、종류배사인자α적질량농도명현저우대조조(P <0.05),량조각시간점백세포개소1β、백세포개소6、종류배사인자α질량농도균명현고우공백대조조(P <0.05).표명응용인공경척막가이강저요추술후인류액중백세포개소1β、백세포개소6、종류배사인자α적질량농도,동시대외주혈염증인자질량농도유경도강저작용.
@@@@BACKGROUND: Research has shown that artificial dura applied for prevention and reduction of lumbar postoperative scarring has achieved good results, but whether it can reduce the releasing of inflammatory cytokines after lumbar surgery is not clear at present. OBJECTIVE: To explore the effects of artificial dura on concentration of inflammation factors in blood and drainage fluid after lumbar surgery. METHODS: A total of 40 patients with prolapse of lumbar intervertebral disc and lumbar spinal stenosis in the Institute of Orthopedics and Traumatology, General Hospital of Beijing Military Area Command of Chinese PLA between March and July 2012, who underwent posterior lumbar decompression, intervertebral disk removal and intervertebral fusion internal fixation, were selected. They were randomly assigned to two groups. Patients using the artificial dura were considered as the experimental group, while the others were considered as the control group. In addition, an additional 10 healthy volunteers were tested as the blank control group. The concentrations of interleukin-1β, interleukin-6 and tumor necrosis factor-α in the blood samples were determined before surgery, at 2 and 3 days fol owing surgery in the three groups. Enzyme-linked immunosorbent assay was used to measure mass concentrations of interleukin-1β, interleukin-6 and tumor necrosis factor-α in drainage fluid at 1, 2 and 3 days after surgery in the experimental and control groups. RESULTS AND CONCLUSION: (1) Drainage fluid: the concentration of interleukin-1β, interleukin-6 and tumor necrosis factor-α at different time points in experimental group was significantly lower than that in the control group (P < 0.05), and there were no fever, al ergies or foreign body rejection in the experimental group. Patients in experimental group had a less oozing compared with the control group (P < 0.05). (2) Blood: the concentrations of interleukin-1β and tumor necrosis factor-α were significantly lower in the experimental group than those in the control group at 3 days (P < 0.05). The concentrations of interleukin-1β, interleukin-6 and tumor necrosis factor-α in the experimental and control groups were significantly higher than those in the blank control group at various time points (P < 0.05). These results suggested that artificial dura can reduce the concentrations of interleukin-1β, interleukin-6 and tumor necrosis factor-α after lumbar surgery in fluid drainage, and slightly decrease the concentrations of inflammatory factors in peripheral blood.