实验性腰椎管狭窄马尾神经动态负荷下血流量的变化  

BLOOD FLOW CHANGES OF CAUDA EQUINA IN EXPERIMENTAL LUMBAR SPINAL CANAL STENOSIS UNDER DYNAMIC BURDEN

作　　者：刘学勇[1] 王欢[1] 吉士俊[2] 玉置哲也 王海义[1] 

机构地区：[1]中国医科大学附属第二医院骨科,沈阳110004 [2]中国医科大学附属第二医院小儿骨科,沈阳110004 [3]日本国和歌山县立医科大学整形外科学教室

出　　处：《中国修复重建外科杂志》2004年第5期406-408,共3页Chinese Journal of Reparative and Reconstructive Surgery

摘　　要：目的　研究高频率刺激 ( high frequency stimulation,HFS)及压迫追加的动态负荷下双节段受压马尾神经血流量的变化 ,探讨神经源性间歇跛行的发病机制。　方法　 SD大鼠 30只 ,分成 5组 ,每组 6只。均行单纯 L5椎板切除 ,检测血流量 1小时后 ,将 4个实验组制成 L4 及 L6 节段 30 %的双节段狭窄。施加静态压迫 2小时后 ,实验 1组不施加动态负荷 ( dynamic burden,DB) ;实验 2组只施加 HFS 6分钟 ;实验 3组同时施加 HFS和压迫追加 6分钟 ;实验 4组只行压迫追加 6分钟 ;对照组为单纯 L5椎板切除及 HFS 6分钟。应用激光多普勒血流仪检测马尾神经血流量。　结果对照组马尾神经血流量在最初 2小时无显著变化 ,施加 HFS时显著升高至初始值的 186 .4 %± 31.5 % ( P<0 .0 5 )。实验1组血流量为 110 .4 %± 7.5 % (与初始值比较 ,P>0 .0 5 ) ;实验 2组血流量无显著变化 111.6 %± 17.6 % (与初始值比较 ,P>0 .0 5 ) ;实验 3组血流量降至初始值的 6 5 .3%± 10 .7% ( P<0 .0 5 ) ;实验 4组血流量降至初始值的 6 0 .1%± 9.2 %( P<0 .0 1) ,与实验 3组无显著差异 ( P>0 .0 5 )。　结论　神经电活动增加时 ,马尾神经双节段压迫可造成其相对缺血 ;若压迫程度同时增加 ,马尾神经血流量显著降低 。Objective To study the changes of blood flow of the already compressed cauda equina under dynamic burden, high frequency stimulation (HFS) and increased additional compression, and to clarify the mechanism of neurogenic intermittent claudication. Methods Thirty SD rats were divided into 5 groups, 6 in each. All groups were operated with laminectomy of the fifth lumbar verfebra. One hour after the measurement of blood flow,in 4 experimental groups, the silicon sheets were inserted into the spinal canal of L 4 and L 6 to cause double level compression of cauda equina by 30%. Two hours after onset of compression, no dynamic burden was introduced to the subjects of the experimental group 1. Only HFS was introduced to the subjects of the experimental group 2 for 6 minutes. Both HFS and increased additional compression were introduced to the subjects of the experimental group 3 for 6 minutes. While only increased additional compression was introduced to the subjects of the experimental group 4 for 6 minutes. The subjects of control group only underwent laminectomy of the fifth lumbar vertebra and HFS 6 minutes. The blood flow of cauda equina was measured with laser Doppler flowmeter. Results In the first 2 hours, there was no significant change of cauda equina blood flow in the control group. During the time of HFS, the blood flow increased significantly to 186.4%±31.5% of initial value ( P <0.05). In the experimental group 1, there was no blood flow change during the period of dynamic burden(110.4%±7.5%, P >0.05). After introduction of dynamic burden, there was no blood flow changes in the experimental group 2 (111.6%±17.6%, P >0.05). The blood flow in the experimental group 3 decreased to 65.3%±10.7% of initial value ( P <0.05); and the blood flow in the experimental group 4 decreased to 60.1%±9.2% of initial value ( P <0.01). There was no significant difference between the experimental groups 3 and 4 ( P >0.05). Conclusion The results above show that during the period of increased imp

关 键 词：血流量 马尾神经 HFS 压迫 实验 椎板切除 对照组 变化 电活动 SD大鼠 

分 类 号：R681.5[医药卫生—骨科学]