摘要
目的探讨不同栓塞剂与脊髓缺血性损害的关系。方法使用明胶海绵、碘油作栓塞剂栓塞双侧肋间动脉(T7～9),造成脊髓的缺血。选取健康成年犬12只,分成两组,即明胶海绵栓塞组、碘油栓塞组,每组各6只。栓塞双侧肋间动脉,造成脊髓缺血,记录前肢正中神经和后肢腓神经到皮层体感诱发电位SEPs的峰值、潜伏期,计算出后肢/前肢到皮层电位的峰值的比率(LE/UE),与病理、运动功能对照。结果脊髓的功能与病理对照:两组术前LE/UE的基值为0.49±0.07,基值的范围是0.22～0.92;两组在术后0.5h分别与术前相比差异有显著性意义;明胶海绵栓塞组SEPs的峰值1h后恢复正常,碘油栓塞组1h不能恢复或引不出。潜伏期也出现同样变化。碘油栓塞组脊髓损伤可以造成单侧脊髓节段前角、前索、外侧索和(或)双侧整个节段神经细胞变性、坏死和液化。而明胶海绵栓塞组大部分动物脊髓病理检查未见改变,仅有1只出现轻度变性,运动功能3级,术后第3d逐渐恢复。结论明胶海绵栓塞犬双侧肋间动脉,大部分没有造成脊髓损害;碘油栓塞犬双侧肋间动脉,则造成脊髓的严重损害。但SEPs不能全面评价术后脊髓运动功能的恢复。
Objective To investigate the relationship between the different embolization agent and the spinal cord ischemic injury. Methods Bilateral of intercostal arteries were embolized with gelatin sponge and lipiodol to block the blood supply of spinal cord. To detect the somatosensory evoked potentials(SEPs), 6 canines in both groups of gelatin sponge and lipiodol were treated by bilateral intercostal arteries embolization. The median nerve and fibular nerve were recorded and the ratio of lower extremity to upper extremity SEPs amplitude (LE/UE ratio) were calculated; the results were compared with the pathologic findings and the motor function. Results The baseline, LE/UE, evoked potential amplitude ratios in all dogs before operation ranged from 0.22 to 0.92 with a combined total mean of 0.49±0.07. The SEPs changes at 30 minutes post operation were more obvious than pre operation in gelatin sponge group and lipiodol group with statistic significance. The LE/UE ratio of gelatin sponge group recovered one hour after operation, but this was absent in lipiodol group. So did the latency SEPs changes. Conclusion The SEPs could not be used to evaluate the motor function of spinal cord comprehensively.
出处
《中华骨科杂志》
CAS
CSCD
北大核心
2001年第9期562-565,共4页
Chinese Journal of Orthopaedics
基金
国家"九五"攻关课题(969070303)
关键词
脊髓
吸收性明胶海绵
碘油
运动诱发电位
栓塞剂
Spinal cord
Gelatin sponge, absorbable
Iodized oil
Evoked potentials, motor
