脊髓压迫时间与后期病理生理变化关系的研究

目的研究持续性脊髓压迫的时间与脊髓损伤的程度及功能恢复是否有相关性。方法在体感诱发电位(SEP)监测下,水囊压迫T13节段脊髓,压力持续30min或180min,比较不同时期(t=0、5、10、15……)SEP的变化情况以及减压后早期(60min)及晚期(28天)的SEP恢复情况。观察28天内动物运动功能。28天后通过病理组织学分析确定损伤的范围。结果30min组动物后肢的运动功能可以较快恢复,但180min组动物的运动功能不能恢复。脊髓病理组织学分析表明180min组脊髓损伤范围与30min组具有显著性差异病理改变与运动功能的恢复具有相关性。结论脊髓长期的移位加重继发性损伤过程,并导致SEP幅度持续降低,血流量持续降低,功能恢复受限及更大范围的组织损害。减压的时间是提高功能恢复的关键因素。

Research of Relationship Between the Time of Spinal Cord Compression and Long-term Change of Pathophysiology

Objective This paper is to explore whether there is a relationship between the duration of sustained spinal cord compression and the extent of spinal cord injury and neurological recovery after decompression.Methods With the somatosensory evoked potentials being consistenly monitored,a hydraulic piston was suspended over the dura and attached to the transvere processes of T13.Funtional motor recovery was judged throughout a twenty-eight day period after the injury.The volume of the lesion and damage to the tissue were assessesed with histological analysis.Results Motor test demonstrated rapid recovery of hindlimb motor funtion in the thiry-minute-compression group,but there was considerable impairment in the 180 minute-compression group.The longer duration of compression produced lesions of significantly greater volume which corresponded to the long-term functional outcome.Conclusions Longer period of displacement allows propagation of the secondary injury progress resulting in a lack of recovery of somatosensory evoked potentials,continuous decline of spinal cord blood flow,and limited functional recovery and more extensive tissue damage.And the time is the most important factor of neurological recovery.