论文部分内容阅读
目的 :探讨快速交换球囊扩张导管技术制备兔单纯脊髓压迫损伤模型的可行性。方法 :将24只新西兰大白兔随机分为3组,麻醉成功后备皮,以T10为中心取背部正中切口,长约4cm,显露T8~T11,假手术组(A组)行T8一侧椎板切除,不置入球囊;对照组(B组)将T8一侧椎板切除后置入球囊达T10水平,不扩张球囊;实验组(C组)行T8一侧椎板切除后,将球囊通过T8置入达T10水平,将球囊快速充起,占据椎管前后径约30%,术中采用CT平扫确定球囊位置并记录球囊扩张达到占位程度时的压强值并维持此压强值压迫48h。术前和术后48h行体感诱发电位(SSEP)检查并记录图形和数值变化,采用改良Tarlov评分记录各组术后48h动物后肢活动情况。同时记录各组兔术后1d、2d体重下降值和饮食量。术后2d各组随机选取5只实验兔取出以T10为中心脊髓组织进行病理学检查,每组剩余3只均以T8为中心上下约0.5cm范围进行拆线,B、C组将球囊内压力减为负压后将球囊轻轻抽出,最后缝合切口,继续观察并记录术后4d、7d、14d时体重下降值及饮食量。结果:C组造模球囊扩张达到椎管前后径30%占位程度时球囊内压强为67.23±22.34k Pa,95%置信区间为(48.55~85.91)k Pa。造模术后C组SSEP波幅显著性降低,与A、B组术后及C组术前比较均有统计学差异(P<0.05),A组与B组比较差异无统计学意义(P>0.05)。造模后48h改良Tarlov评分A组(6.00±0.00分)与B组(5.88±0.35分)比较差异无统计学意义(P>0.05),A、B组与C组(1.13±0.35分)比较差异均有统计学意义(P<0.05)。术后1d、2d、4d、7d、14d时3组兔体重下降值及饮食量均无统计学差异(P>0.05),术后14d时体重恢复至正常体重,术后7d时饮食恢复正常。结论:快速交换球囊扩张导管技术制备兔单纯脊髓压迫损伤模型可模拟临床急性脊髓压迫损伤的状态。
OBJECTIVE: To investigate the feasibility of rapid exchange balloon catheterization in the preparation of a simple spinal cord compression injury model in rabbits. Methods: Twenty-four New Zealand white rabbits were randomly divided into three groups. After anesthesia was successful, the skin was prepared and T10-T11 was taken as the center, The control group (group B) placed the T8 laminectomy tube into the balloon and reached the level of T10 without balloon dilation. In the experimental group (group C), one side of the T8 laminectomy was performed, The balloon through the T8 into the T10 level, the balloon filled quickly, occupy the anteroposterior diameter of spinal canal about 30%, intraoperative CT scan to determine the location of the balloon and record the degree of inflation of the balloon to reach the level of pressure And maintain the pressure value of pressure 48h. Preoperative and postoperative 48hwent somatosensory evoked potential (SSEP) examination and record the changes in the value of the graph and the value of improved Tarlov score recorded after 48h animal hindlimb activity. At the same time, each group of rabbits after 1d, 2d weight loss and diet. At 2 days after operation, 5 rabbits in each group were randomly selected to take T10 as the central spinal cord tissue for pathological examination. The remaining 3 in each group were stitched up and down about 0.5cm around T8. B and C groups, After the pressure was reduced to a negative pressure, the balloon was gently pulled out, and the incision was finally sutured. The weight loss and diet on the 4d, 7d and 14d after operation were observed and recorded. Results: The intracapsular pressure was 67.23 ± 22.34 kPa and the 95% confidence interval (48.55 ~ 85.91) kPa when balloon dilatation of C group was 30% of anteroposterior diameter. The amplitude of SSEP in group C after operation was significantly lower than that in group A and B (P <0.05), but there was no significant difference between group A and group B (P> 0.05). There was no significant difference between the modified Tarlov score A group (6.00 ± 0.00 points) and the B group (5.88 ± 0.35 points) at 48 hours after modeling (P> 0.05) The differences were statistically significant (P <0.05). At 1, 2, 4, 7 and 14 days after operation, there was no significant difference in body weight loss and diet between the three groups (P> 0.05). At 14 days after operation, the body weight returned to normal weight and the diet returned to normal after 7 days. CONCLUSION: Rapid exchange balloon dilatation catheter technique can be used to simulate the condition of acute spinal cord compression injury in rabbits.