论文部分内容阅读
目的通过研究兔胸椎管形态结合体感诱发电位(SEP)建立一种胸椎双节段脊髓慢性压迫模型。方法首先对兔新鲜胸椎标本作详细的解剖学研究,选定2F Fogarty球囊导管作为压迫模型所用的球囊。成年新西兰大白兔30只,随机分为对照组(球囊不扩张)、40μl压迫组、50μl压迫组。通过T_6、T_7椎板的小孔,将导管置入硬膜外腔,再分别向头尾端插入到T_3、T_(10)水平。通过皮层SEP、Tarlov’s评分、X线片及CT检查、脊髓HE染色评价该模型的可靠性。结果 40μl压迫组T_3脊髓压迫率为(42.81±5.54)%,T10脊髓压迫率为(44.74±5.85)%。50μl压迫组T3脊髓压迫率为(62.52±1.91)%,T_(10)脊髓压迫率为(63.77±2.06)%。球囊扩张后7 d 40μl压迫组SEP开始逐渐恢复,至术后28 d趋于稳定,与压迫后即刻比较SEP的潜伏期明显缩短,波幅增高,差异有统计学意义(P<0.05);50μl压迫组术后SEP改变差异无统计学意义(P>0.05)。40μl压迫组、50μl压迫组的SEP波幅较对照组明显降低,潜伏期明显延长,差异有统计学意义(P<0.05);但40μl压迫组与50μl压迫组间差异无统计学意义(P>0.05)。结论 SEP对早期脊髓损伤诊断具有敏感性和特异性,并且能反应脊髓损伤程度。脊髓压迫率为62%~64%的压迫模型的SEP更稳定,模型更可靠。
Objective To establish a double-section chronic spinal cord compression model of thoracic spine by studying the relationship between rabbit thoracic spinal canal morphology and somatosensory evoked potential (SEP). Methods First of all, the fresh thoracic vertebrae specimens were carefully dissected. 2F Fogarty balloon catheter was selected as the balloon for compression model. Thirty adult New Zealand white rabbits were randomly divided into control group (noninvasive balloon), 40μl oppression group and 50μl oppression group. The catheters were inserted into the epidural space through the small holes in T_6 and T_7 laminae, and then inserted into the epidural space respectively to the tail end of T_3 and T_ (10). The reliability of the model was evaluated by cortical SEP, Tarlov’s score, X-ray and CT examination and HE staining of spinal cord. Results The compression rate of T 3 spinal cord in the 40μl compression group was (42.81 ± 5.54)%, and the compression rate of T10 spinal cord was (44.74 ± 5.85)%. The spinal cord compression rate of T3 was (62.52 ± 1.91)% and that of T10 (63.77 ± 2.06)% in 50μl compression group. At 7 days after balloon dilation, SEP began to recover gradually in 40μl compression group, and stabilized at 28 days postoperatively. The latency of SEP was significantly shortened and amplitude increased immediately after compression (P <0.05) There was no significant difference in postoperative SEP changes between the two groups (P> 0.05). Compared with the control group, the amplitude of SEP in 40μl oppression group and 50μl oppression group was significantly lower than that in control group (P <0.05), but there was no significant difference between 40μl oppression group and 50μl oppression group (P> 0.05) . Conclusion SEP is sensitive and specific for the diagnosis of early spinal cord injury and can reflect the degree of spinal cord injury. SEP with a compression rate of 62% to 64% in spinal cord compression is more stable and the model is more reliable.