体感诱发电位在建立双节段脊髓压迫模型中的作用  

Role of evoked potentials in building a spinal cord compression model of double segment

作　　者：杨超华[1] 禹宝庆[1] 乔建兰[2] 唐雨佳[3] 冯建军[1] 

机构地区：[1]复旦大学附属浦东医院骨科,上海201399 [2]复旦大学附属浦东医院放射科,上海201399 [3]复旦大学附属浦东医院神经内科,上海201399

出　　处：《中国骨与关节损伤杂志》2017年第1期53-56,共4页Chinese Journal of Bone and Joint Injury

基　　金：上海市卫生局科研课题(20124300)

摘　　要：目的通过研究兔胸椎管形态结合体感诱发电位(SEP)建立一种胸椎双节段脊髓慢性压迫模型。方法首先对兔新鲜胸椎标本作详细的解剖学研究,选定2F Fogarty球囊导管作为压迫模型所用的球囊。成年新西兰大白兔30只,随机分为对照组(球囊不扩张)、40μl压迫组、50μl压迫组。通过T_6、T_7椎板的小孔,将导管置入硬膜外腔,再分别向头尾端插入到T_3、T_(10)水平。通过皮层SEP、Tarlov's评分、X线片及CT检查、脊髓HE染色评价该模型的可靠性。结果 40μl压迫组T_3脊髓压迫率为(42.81±5.54)%,T10脊髓压迫率为(44.74±5.85)%。50μl压迫组T3脊髓压迫率为(62.52±1.91)%,T_(10)脊髓压迫率为(63.77±2.06)%。球囊扩张后7 d 40μl压迫组SEP开始逐渐恢复,至术后28 d趋于稳定,与压迫后即刻比较SEP的潜伏期明显缩短,波幅增高,差异有统计学意义(P<0.05);50μl压迫组术后SEP改变差异无统计学意义(P>0.05)。40μl压迫组、50μl压迫组的SEP波幅较对照组明显降低,潜伏期明显延长,差异有统计学意义(P<0.05);但40μl压迫组与50μl压迫组间差异无统计学意义(P>0.05)。结论 SEP对早期脊髓损伤诊断具有敏感性和特异性,并且能反应脊髓损伤程度。脊髓压迫率为62%~64%的压迫模型的SEP更稳定,模型更可靠。Objective To establish stably a chronic compression animal model of double segmental at thoracic cord by the study on the morphology of thoracic spinal canal and evoked potential in rabbits. Methods First, detailed anatomical studies were performed for the fresh thoracic spinal canal in rabbits, and the 2F Fogarty balloon catheter was selected for the compression model. A total of 30 adult rabbits were randomly divided into three groups： control （Fogarty catheter inserted but not inflated）, 40 μl compression group, 50μl compression group. Two Fogarty catheters were inserted into the epidural space through the hole in T6、7 and advanced rostrally or caudally to T3 or T10 level, respectively. The reliability of the model was assessed by Tadov＇s scores, somatosensory evoked potentials（SEPs）, radiographic imaging and hematoxylin-eosin（H＆E） stained of spine cord. Results The rates of spinal cord compression under 40 μl of balloon inflation at T3 and T10 were. （42.81±5.54）% and （44.74±5.85）%, and those under 50μl of balloon inflation were （62.52±1.91）% and （63.77±2.06）%, respectively. In the 40 μl compression group, SEPs began to recover at 7 days post-compression, and tended to be stable 28 days after the operation. The latency was shortened and the amplitude was increased compared with the SEPs immediately after compression （P 〈0.05）; However, there was no significant difference in SEPs in the 50μl compression group （P 〉0.05）. The latency was prolonged and the amplitude was decreased in the 40 and 50μl compression groups than the SEPs in the control group （P 〈 0.05）; However, there was no significant difference in SEPs in the 40 and 50μl compression groups （P 〉0.05）. Conclusion The evoked potentials are sensitive and specific for early diagnosis of spinal cord injury, which could be an indicator for the extent of damage of the spinal cord. The model is more reliable and the somatosensory evoked potential is more stable at a rate of 62%-64% compres

关 键 词：体感诱发电位 双节段脊髓压迫 球囊压迫 动物模型 

分 类 号：R-33[医药卫生]