动脉阻断致颈髓急性缺血性损伤的实验研究  

Experimental study on ischemic injury of certical spinal cord after acute artery block

作　　者：孙其志[1] 任先军[2] 胡宏伟[1] 孙磊[1] 国华[1] 廖可国[1] 

机构地区：[1]济南军区第88医院骨科,泰安271000 [2]第三军医大学新桥医院骨科,重庆400037

出　　处：《中国矫形外科杂志》2006年第20期1567-1570,共4页Orthopedic Journal of China

摘　　要：[目的]研究颈髓脊髓前动脉、前根动脉阻断对颈髓缺血性损伤的影响。[方法]将48只家兔随机分为阻断脊髓前动脉组和间接阻断前根动脉组(阻断脊髓前动脉+双侧椎动脉),两组均设有对照组。每组各在术后6、24、72 h检测颈髓血流灌注量,运动诱发电位、组织能量代谢变化,电镜观察细胞形态学改变。[结果]脊髓前动脉阻断后颈髓前部表面血流量下降了50.28%,随后有所回升;运动诱发电位潜伏期延长;ATP和EC进行性下降,出现急性缺血性改变;间接阻断前根动脉组其各指标变化更加明显,同阻断脊髓前动脉相比,存在显著差异,P<0.05。[结论]脊髓前动脉对颈髓前部血流起着重要的作用,阻断后造成脊髓缺血性损伤,但有部分代偿;前根动脉对颈髓血供有重要的补充和支持作用,临床上各种原因造成的根动脉损伤势必对颈髓带来损害。[ Objective] To study the effect on ischemic injury of cervical spinal cord[ CSC ] by comparison on two different blocks of arteries supplying CSC. [ Method ] Forty-eight rabbits were divided into two groups ： Group A, ligation and section of anterior cervical spinal cord artery（ ASCA ） ; group B ligation and section of both ACSCA and bilateral vertebral arteries before its entramce the foraman （indirect block of Anterior cervical radicular artery （ACRA）. Bdood flow changes of CSC were meansured after 6 h, 24 h and 72 h （each N = 6） and muscle motor cooked potential （MMEP）, local energy metabolism, and cell morplotogieal changes of CSC were observed. [ Result] In group A, blood flow of CSC was going down markedly and showed 50.2% decrease, but got partial recovery at 24 h and 72 h. Delitescence of MMEP prolongcd, ATP and EC descended profressivtly, showing an ischemic changes, In group B there showed greate, changes about every observation thay that in group A with significant difference at every time poinl between two groups（ P 〈0.05 ）. [ Conclusion] ACSCA is very important in supplying blood flow of CSC, it＇s block will resuhin decrease of CSC blood flow and local energy metabotism, progressive lesions of tissue and ceel and disfunction of CSC. Additional injury of ACRA of CSC will affravale the tesions.

关 键 词：脊髓前动脉 前根动脉 阻断 缺血 颈髓 

分 类 号：R651.2[医药卫生—外科学]