脊髓前动脉损伤后脊髓病理演变的实验研究  

The Pathological Study of Spinal Cord Ischemia Caused by Anterior Spi nal Artery Injury in Canines

作　　者：沈康平[1] 李家顺[1] 贾连顺[1] 尹经正[2] 刘昀[3] 彭宝淦[4] 宋海涛[1] 许斌[1] 

机构地区：[1]第二军医大学附属长征医院骨科,上海200003 [2]喀什卫生学院病理科 [3]新疆第二军医大学附属长海医院病理科 [4]中国人民解放军304医院骨科

出　　处：《中国矫形外科杂志》2002年第13期1308-1310,共3页Orthopedic Journal of China

摘　　要：目的 :观察脊髓前动脉损伤后脊髓组织形态学演变过程 ,研究病理机制。方法 :以家犬为实验模型 ,损伤脊髓前动脉后进行肉眼、光镜和电镜动态观察 ,定量测定坏死神经元。结果 :脊髓前动脉损伤 2h运动神经元变性 ,轴索病变 ,6h神经元坏死 ,2 4h脊髓水肿达到高峰 ,7d髓内出血最明显。在脊髓前动脉损伤节段 ,2 4h 30 %～ 40 %的运动神经元坏死 ,3d达 80 % ,7d以后 95 %以上。病变均位于脊髓 2 / 3。脊髓前动脉损伤节段变性坏死最严重 ,相邻节段其次 ,尾侧脊髓坏死量逐渐减少。结论 :脊髓前动脉损伤后脊髓缺血性病变是渐进和不可逆的 。Objective:To observe the histomorphologica l outcome of medullary ischemia caused by anterior spinal cord artery injury,research the pathologic mechanism.Methods:I njured cervical anterior spinal artery.The pathology of spinal cord was observed grossly and under light microscope as well as transmission electron microscope, and determined quantificationally the necrotic motor neurons.Results:Within 2 ho u rs of anterior spinal artery injury,axonal and motor neurons degeneration occurr ed.At 6 hours postischemia motor neurons necrosis were shown.Edema and demyelina tion was observed distinctly in spinal cord at 24 hours,however,motor neurons ne crosis and hematomyelia worsened with time so that by 7 days.The pathological ch anges involved primarily only the ventrocolumna,funiculus anterior and funiculus lateralis of spinal cord.Motor neurons necrosis spreaded into adjacent segments of the cord,and extended more prominently to the caudal side of spinal cord.Con cl usions:After cervical anterior spinal artery injury,the evolution of pathologica l changes was gradual and irreversible.Motor neurons necrosis more significantly extended to adjacent segments and caudal side.

关 键 词：脊髓前动脉损伤 脊髓病理演变 实验研究 脊髓缺血 动物实验 

分 类 号：R651.2[医药卫生—外科学] R744.[医药卫生—临床医学]