不同预防硬膜外粘连的方法对神经电生理功能的影响  

Spinal Cord and Nerve Roots Conduction Implicated by Laminectomy and Various Methods for the Prevention of Epidural Adhesion: An Experimental Study in Rabbits

作　　者：庞祖才[1] 李永军[1] 谭赞全 许汉权[1] 谢伟坚[1] 李文任 陈棉智 陈镇秋[1] 

机构地区：[1]广东省佛山市顺德中西医结合医院骨科,佛山528333

出　　处：《现代临床医学生物工程学杂志》2006年第2期106-107,134,共3页Journal of Modern Clinical Medical Bioengineering

基　　金：广东省医学科学技术研究基金资助项目(WSTJJ2000122842010664011447);顺德科技计划项目(顺科字[2002]21号)

摘　　要：目的探索预防硬膜外粘连的几种方法对脊髓、神经根传导功能的影响。方法40只新西兰白兔随机分为4组。切除L5椎板造成12mm×6mm硬脊膜裸露区,探查神经根。A组注入生理盐水1ml,B组充填高分子量透明质酸钠凝胶1ml,C组用自体L6棘突重建L5椎板,D组用透明质酸钠凝胶充填后再进行L5椎板重建。分别检查术前、术后即刻、术后1、3、6周腓肠肌诱发肌电图,记录M波、H波。结果术后H波潜伏期显著延长,B、D组1周恢复正常,C组3周恢复正常,A组6周恢复正常。M波手术前后潜伏期无明显差异。M波、H波波幅个体差异大,手术前后无明显差异。结论通过测定肌肉动作电位H波潜伏期可灵敏反映神经根、脊髓传导功能;透明质酸钠凝胶能促进脊髓、神经根传导功能的恢复。Objective To determine the electrophysiological changes of spinal cord and nerve roots after laminectomy. Methods Laminectoroy was performed in lumbar 5 segment in 40 rabbits which were divided into 4 groups. 12mm × 6mm dura mater was exposed, and left uncovered in group A, covered with sodium hyaluronate in group B, lamina repair with autologous spinous process in group C, with both above materials in group D. The changes of muscle active potential were measured before and after Laminectomy, and at 1, 3, 6 weeks postoperation. Results H reflex was significant delayed after laminectomy. It recovered after 1 week in group B and D, but 3 weeks in group A and C. M waves was not significant change after laminectomy in groups. Conclusious It was concluded that the latent period of H reflex can provide immediate feedback of spinal cord and nerve roots injury. Sodium hyaluronate can improve the physiological function recovery of spinal cord and nerve roots.

关 键 词：椎板切除术 硬膜外粘连 电生理 

分 类 号：R687.3[医药卫生—骨科学]