快速交换球囊扩张导管技术制备兔急性脊髓压迫损伤模型

A rabbit model of acute spinal cord compression injury by rapid exchange balloon dilatation catheter

中文关键词:  脊髓损伤  脊髓压迫症  快速交换球囊扩张导管

英文关键词:Spinal cord injuries  Spinal cord compression  Rapid exchange balloon dilatation catheter

中文摘要:

  【摘要】 目的：探讨快速交换球囊扩张导管技术制备兔单纯脊髓压迫损伤模型的可行性。方法：将24只新西兰大白兔随机分为3组，麻醉成功后备皮，以T10为中心取背部正中切口，长约4cm，显露T8~T11，假手术组（A组）行T8一侧椎板切除，不置入球囊；对照组（B组）将T8一侧椎板切除后置入球囊达T10水平，不扩张球囊；实验组（C组）行T8一侧椎板切除后，将球囊通过T8置入达T10水平，将球囊快速充起，占据椎管前后径约30％，术中采用CT平扫确定球囊位置并记录球囊扩张达到占位程度时的压强值并维持此压强值压迫48h。术前和术后48h行体感诱发电位（SSEP）检查并记录图形和数值变化，采用改良Tarlov评分记录各组术后48h动物后肢活动情况。同时记录各组兔术后1d、2d体重下降值和饮食量。术后2d各组随机选取5只实验兔取出以T10为中心脊髓组织进行病理学检查，每组剩余3只均以T8为中心上下约0.5cm范围进行拆线，B、C组将球囊内压力减为负压后将球囊轻轻抽出，最后缝合切口，继续观察并记录术后4d、7d、14d时体重下降值及饮食量。结果：C组造模球囊扩张达到椎管前后径30%占位程度时球囊内压强为67.23±22.34kPa，95％置信区间为（48.55～85.91）kPa。造模术后C组SSEP波幅显著性降低，与A、B组术后及C组术前比较均有统计学差异（P<0.05），A组与B组比较差异无统计学意义（P>0.05）。造模后48h改良Tarlov评分A组（6.00±0.00分）与B组（5.88±0.35分）比较差异无统计学意义（P>0.05），A、B组与C组（1.13±0.35分）比较差异均有统计学意义（P<0.05）。术后1d、2d、4d、7d、14d时3组兔体重下降值及饮食量均无统计学差异（P>0.05），术后14d时体重恢复至正常体重，术后7d时饮食恢复正常。结论：快速交换球囊扩张导管技术制备兔单纯脊髓压迫损伤模型可模拟临床急性脊髓压迫损伤的状态。

英文摘要:

  【Abstract】 Objectives: To investigate the operation process and effect of rapid exchange balloon dilatation catheter to induce the model of acute spinal cord compression injury(SCI). Methods: Spinal cord compression injury model was introduced in 24 New Zealand white rabbits. The models were randomly divided into 3 groups. A 4cm median incision was taken to expose T8 to T11 after narcosis, then a side of T8 vertebral plate was removed. Rabbits in group A only received the laminotomy without insertion of balloon; in group B, the balloons were surgically positioned in the T10 spinal canal but not inflated; in group C, the balloons were put through T8 into T10, and the spinal cords were compressed by inflating the balloon to reduce about 30% of anteroposterior vertebral canal diameter. Computed tomography(CT) was used to show the location of balloon and kept the record of all the pressure for 48h. The modified Tarlov motor function grade test and SSEP were applied to evaluate the motor function of hind limbs before and at 48h after surgery. Then the weight loss and dietary were recorded change every day. Finally, 5 rabbits from each group were randomly selected and spinal cord in the center of T10 was taken out to take the histological examination. The pressure in balloon was reduced to negative pressure before taking out the balloons in group B and group C, the other 3 cases in each group continued to be taken the weight loss and dietary change at 4d, 7d, 14d after operation. Results: The 95% confidence interval of pressure was 48.55-85.91kPa(mean, 67.23±22.34kPa) in group C. The SSEP showed that motor function was seriously damaged in group C. The SSEP in group C after surgery was significantly different from group A and B(P<0.05). However, the SSEP did not show statistically difference between group A and B(P>0.05). The differences of weight loss and dietary change at 1d, 2d, 4d, 7d, 14d after operation were not statistically significant among the 3 groups(P>0.05). The weight recovered to normal at the 14th of day post-operation. The diet returned to normal at 7d of post-operation. While group C had lower modified Tarlov motor function grade than group A and B(P<0.05). The difference of modified Tarlov motor function grade was not statistically significant between group A and B(P>0.05). Conclusions: A model of acute spinal cord injury by using the compression with rapid exchange balloon dilatation catheter is successfully induced. It can well simulate the clinical situations of SCI.