周围神经阻滞麻醉对脊髓生物学的影响  

Biological effects of peripheral nerve block on the spinal cord

作　　者：李霞[1] 张勇[1] 张京[1] 

机构地区：[1]新疆医科大学第五附属医院麻醉科,新疆维吾尔自治区乌鲁木齐市830011

出　　处：《中国组织工程研究》2013年第37期6594-6600,共7页Chinese Journal of Tissue Engineering Research

摘　　要：背景:周围神经阻滞麻醉后是怎样产生功能抑制的,对脊髓和大脑中枢有何影响,是怎样调节周围神经的,中枢在解剖形态上有何改变,目前尚不明确。目的:观察周围神经阻滞麻醉对脊髓神经细胞生物学的影响。方法:将60只新西兰大白兔随机分为坐骨神经阻滞麻醉组、蛛网膜下腔阻滞麻醉组和硬膜外腔阻滞麻醉组,每组20只;每组再分实验组和对照组,每组10只。坐骨神经阻滞麻醉组的实验组在股骨头与坐骨结节连线中点注射利多卡因,蛛网膜下腔阻滞麻醉组的实验组在蛛网膜下腔注射布比卡因,硬膜外腔阻滞麻醉组的实验组在硬膜外腔注射利多卡因,各组的对照均在相同部位注射生理盐水。结果与结论:坐骨神经阻滞麻醉、硬膜外腔阻滞麻醉或蛛网膜下腔阻滞麻醉30 min后,均有相应节段脊髓灰质后角Ⅲ、Ⅳ板层小圆细胞、前角Ⅸ板层外侧大多角细胞的尼氏体减少,核偏向一端,c-Fos蛋白表达减弱或无表达,提示脊髓相应节段的神经细胞功能受到抑制;另外蛛网膜下腔阻滞麻醉后,脊髓软脊膜有分层或断裂现象。BACKGROUND： How does the peripheral nerve block work to inhibit the functions？ What effects does it do to the spinal cord and the cerebral center？ How does it regulate the peripheral nerve and how does it change anatomy of brain center？. All above are still unknown. OBJECTIVE： To observe the effect of peripheral nerve block on the biology of spinal cord nerve cells. METHODS： Sixty New Zealand rabbits were selected and randomly divided into three groups： ischiadic nerve block group, subarachnoid block group and extradural nerve block group. Each group had 20 rabbits which were sub-divided into experimental group and control group with 10 rabbits in each subgroup. The rabbits in the three experimental groups were injected with lidocaine, bupivacaine and lidocaine at the middle point between femoral head and ischiadic tuberosity in ischiadic nerve block group, subarachnoid block group and extradural nerve block group, respectively. The rabbits in each control group were injected with normal saline at the same position. RESULTS AND CONCLUSION： After ischiadic nerve block, extradural nerve block or subarachnoid block for 30 minutes, the Nigeria＇s bodies of the little round cells in the poliomyelia posterior horn laminae III and IV and the polyhedral cells in the anterior horn laminae IX were less than those in the control groups. Nuclei leaned towards one side. c-Fos protein expression was decreased or showed noexpression, suggesting that the cord nerve cell function of corresponding spinal segments was inhibited. The spinal pia mater of spinal cord had a hierarchical or fracture phenomenon after subarachnoid block.

关 键 词：周围神经 麻醉 神经元 生物学 

分 类 号：R318[医药卫生—生物医学工程]