副神经移位膈神经后高位颈髓损伤大鼠血气分析指标变化特点研究  

Research about the changing features of the blood gas analysis after transposition of accessory to phrenic nerve in reconstruction of respiratory function with upper cervical cord injuries

作　　者：张咏[1] 周许辉[1] 叶晓健[1] 袁文[1] 贾连顺[1] 

机构地区：[1]第二军医大学长征医院骨科,上海200003

出　　处：《中国矫形外科杂志》2011年第2期127-130,共4页Orthopedic Journal of China

基　　金：国家自然科学基金资助项目(编号:30571886)

摘　　要：[目的]探讨副神经移位膈神经重建高位颈髓损伤大鼠呼吸功能时血气分析指标的变化特点。[方法]健康雄性SD大鼠60只。随机分为1、2、3、4、5、6个月6个时间组。取下颈部正中切口,将双侧副神经在锁骨下水平发出内、外侧支之前切断,移位缝接膈神经干起始部。术后第1、2、3、4、5、6个月各组样本取颈后正中切口,切除C3全椎板充分显露颈髓并于C3、4水平锐性横断。分别于横断C3、4脊髓后10、30 min于颈总动脉处插管抽取动脉血各0.2 ml。利用ABL50型血气分析仪(雷度公司,丹麦产)进行pH值、氧分压、二氧化碳分压及血氧饱和度的监测。此后,每30 min检测1次。同时测定10只正常SD大鼠血气指标作为对照。[结果]C3、4脊髓横断后10 min,第1、2个月组大鼠呼吸停止,血氧饱和度为0及(1.9±0.7)%。3个月组大鼠表现出严重呼吸性酸中毒,pH值为7.19±0.04,PCO2为(73.5±6.17)mmHg(1 mmHg=0.133 kPa),PO2为(32.7±4.26)mmHg,SO2为50.7%±8.93%,(18±5)min后呼吸停止。4个月组大鼠出现轻度CO2潴留,SO2为(88.6±4.02)%,30 min后为(57.1±6.27)%。5、6个月组大鼠血气分析指标正常,正常值维持时间第5个月组为(176.31±22.53)min,第6个月组为(58.70±12.62)h。[结论]从血气分析指标变化来观察,副神经移位膈神经可能是重建高位颈髓损伤后呼吸功能的一种治疗方法。[Objective]To investigate the features of blood gas after nerve transposition in rats with upper cervical cord injuries.[Method]Sixty male adult rats were divided into six time-based groups（1,2,3,4,5,6 months apart） after accessory nerves were cut,and sutured to phrenic nerve trunk.At 1,2,3,4,5,and 6 months after operation,C3 laminectomy and the cervical spinal cord transect at the levels of C3,4 were performed via cervical posterior approach.Ten and 30 minutes after transecting the cervical spinal cord at the C3,4 levels,0.2 ml of blood from the common carotid artery was teken for measuring the pH value,the partial pressure of oxygen,partial pressure of carbon dioxide and blood oxygen saturation with ABL50 blood-gas analyzer（Denmark）.Tests were repeated every 30 minutes.The blood gas of normal rats（n=10） was also tested.The changing features of the blood gas were studied after accessory nerve transposition and phrenic nerve reconstruction.[Result]Ten minutes after the cervical spinal cords were transected,the rats of 1 and 2 months groups expired.SPO2 was 0 and 1.9%±0.7% respectively.Serious respiratory acidosis occurred in the rats of 3 months group.The pH value was 7.19±0.04,PCO2 was 73.5±6.17 mmHg,PO2 was 32.7±4.26 mmHg and SO2 was 50.7%±8.93%.They expired 18~5 minutes later.The rats of 4 months group suffered slight CO2 retention.SO2 was 88.6%±4.02% and 57.1%±6.72% 30 minutes later.The parameters of blood gas in the rats of 5 and 6 months groups were normal.The normal values maintained 176.31±22.53 minutes in the rats of the 5 months group,and over 6 hours in the rats of the 6 months group.[Conclusion]According to the blood gas analysis,it is easy to find that it is possible for respiratory function rehabilitation by transposition of accessory nerve to phrenic nerve after upper cervical cord injuries.

关 键 词：膈神经 副神经 膈肌 脊髓损伤 

分 类 号：R687.3[医药卫生—骨科学]