腹主动脉局部灌注丙泊酚减轻脊髓缺血-再灌注损伤的研究

目的 建立兔脊髓缺血-再灌注损伤模型，研究经腹主动脉局部灌注丙泊酚对脊髓缺血-再灌注损伤的作用。方法 新西兰大耳白兔30只，随机均分为A、B、C三组，诱导后气管插管，持续监测平均动脉压、心率、脉搏血氧饱和度及肛温。左股动脉切开置管至腹主动脉分出左肾动脉远端1．0cm处，于左肾动脉开口远端0．5cm处阻断腹主动脉，同时阻断双侧髂总动脉，自阻断即刻开始经置入导管分别向阻断的腹主动脉远端灌注5ml／kg丙泊酚溶液（A组）、10％脂肪乳（B组）和生理盐水（C组），30min后开放。于动物完全清醒即刻、再灌注后6、24和48h对双后肢神经功能进行评分，光镜观察脊髓前角正常运动神经元并计数。结果 清醒即刻、再灌注后6、24和48hA组神经行为学评分明显高于B和C组（P〈0．05），B、C两组比较差异无统计学意义。三组脊髓前角正常运动神经元中位数分别为11、1和0，A组明显高于B、C两组（P〈0．05）。结论 腹主动脉阻断期间经阻断的腹主动脉局部灌注丙泊酚可减轻脊髓缺血一再灌注损伤。

Propofol infusion through aorta can relieve ischemic-reperfusion injury of the spinal cord

Objective To investigate the effect of propofol infusion through the aorta on the spinal cord ischemic-reperfusion injury.Methods Thirty New Zealand white rabbits were equally randomized into 3 groups.Under anesthesia with intramuscular ketamine, midazolam and atropine, the rabbits were endotracheally intubated and ventilated.The anesthesia was intravenously maintained with midazolam, fentanyl and vecuronium. The arterial pressure, electrocardiogram, percutaneous O2 saturation, and rectal temperature were continuously monitored.The spinal cord ischemia was induced by infrarenal aortic occlusion for 30min. Meanwhile, the bilateral common iliac arteries were also occluded temporarily.During the occlusion, the rabbits in the 3 groups were respectively infused with the following solutions through a catheter to the distal aorta: 1% propofol 5ml/kg (group A), 10% intralipid 5ml/kg (group B), normal saline 5ml/kg (group C).The neurological status was assessed according to the Tarlov scale system at 6, 24 and 48h after reperfusion.After the last scoring, the lumbar segments of the spinal cord (L4-L6) were taken out under general anesthesia for pathological examination, and the normal motor neurons were counted.Results Fourty-eight hours after reperfusion, the rabbits in group A had significantly better neurological functions than those in groups B and C(P<0.05).There was no significant difference between groups B and C.The histopathological results coincided with the neurological scores, the median numbers of normal motor neurons were 11, 1 and 0 in groups A, B and C,respectively.Conclusion The results indicate that propofol infusion through the aorta during clamping process can relieve the ischemic-reperfusin injury of the spinal cord significantly.