脊髓爆震伤后早期治疗神经元的形态学变化

目的]研究脊髓爆震伤后早期采用不同药物干预对脊髓前角运动神经元影响。方法]将36只家兔随机分为对照组（A组，n=12）、地塞米松实验纽（B组，n=12）、甲强龙实验组（C组，n=12），每组家兔均采用0．9g单质金属炸药黑索金（cyclotrimethylene trinitramine）进行爆震，伤后各组分别给予静脉输入生理盐水、地塞米松及甲强龙，于伤后6h、24h2个时间点取材，在光镜下观察脊髓前角运动神经元形态和数量的改变。结果]发现爆震伤后6h脊髓运动神经元出现可逆性改变，伤后24h脊髓死亡运动神经元显著增加，伤后早期给予地塞米松及甲强龙治疗后，死亡神经元的数量减少与对照组相比有显著的统计学意义（P〈0．001），而B、C组之间无显著差别（P〉0．05）。结论]脊髓爆震伤后早期应用糖皮质激素对运动神经元具有保护作用，在本实验条件下，甲强龙在早期脊髓爆震伤中的疗效与地塞米松相比没有优势。

Morphological changes of spinal motorneurons by early treatment after explosive injury of spinal cord

Objective]To study therapeutic effect of different medicines on motorneuron of spinal cord after explosive injury of spinal cord.Method]Thirty-six rabbits were randomly divided into model group(group A,n= 12),the dexamethasone experiment group(group B,n= 12) and the methylprednisolone experiment group(group C,n=12),all rabbits were made explosive wound by 0.9 g cyclotrimethylene trinitramine,group A injection NS after blast, group B injection dexamethasone and group C injection methylprednisolone,6 and 24 hours after specimen had been taken out,then morphological change and quantity of the spinal motorneurons be observed under light microscopes.Result]The reversible change of the neurons of rabbits happened after six hours,after 24 hours,the died motoneuron increase obviously, some rabbits remedied with dexamethasone and methylprednisolone after explosive injury in group B and C,quantity of the died motorneuron marked significant difference than that in the control group(P<0.001).However,there is no difference between group B and C(P>0.05).Conclusion]Glycocotical stdroid can protect spinal cord motoneurons after explosive injury of spinal cord.In the experiment,there is no preponderance in early treatment of explosive injury of spinal cord between methylprednisolone and dexamethasone.