坐骨神经高速弹丸震荡伤后腰段脊髓运动神经元的超微结构变化(英文)

Ultra-structural changes of the lumbar spinal motor neurons after sciatic nerve injury induced by high-speed steel ball

背景:高速弹丸致伤坐骨神经后,其远隔部位的腰段脊髓会发生何种组织损伤效应?目的:研究坐骨神经高速弹丸震荡伤后腰段脊髓运动神经元的超微结构改变。设计:以实验动物为研究对象,随机对照的验证性研究。单位:一所军医大学医院的野战外科研究所。材料:实验于2001-05/2002-12在野战外科研究所靶道实验室完成。选择SPF日本大耳白兔65只,雌雄不拘,体质量2.5～3.0kg,由第三军医大学大坪医院动物医学实验中心提供。按随机数分为正常对照组5只、火器伤组30只、切割伤组30只,火器伤组和切割伤组观察时相点为伤后1,3d,1,2,4,12周,每时相点5只动物。方法:火器伤组致伤弹丸为0.38g钢珠,装药量0.65g,致伤靶点为兔右后肢外侧坐骨神经体表投影线中点,切割伤组在同一水平切断右坐骨神经。主要结局观察:光电镜下观察伤后1,3d,1,2,4,12周时腰段脊髓的病理改变。结果:火器伤组可见腰段脊髓有小出血灶、神经元水肿、空泡样变、运动神经元数量减少等变化,切割伤组则未见这些病理改变。结论:火器伤组腰段脊髓损伤较切割伤组重,运动神经元存活数量显著减少。

BACKGROUND:What kind of traumatic changes could be observed in remote lumbar s pinal cord after high speed steel ball induced sciatic nerve injury? OBJECTIVE:To study the ultra structural changes of lumbar spinal cord motor ne urons after the sciatic nerve injury due to high speed steel ball. DESIGN:Retrospective randomized controlled study with experimental animals as subjects. SETTING:The field operation research institute of a military medical universit y college. MATERIALS:This study was carried out at the Ballistic Laboratory of Research I nstitute for Surgery from May 2001 to December 2002.Sixty five SPF flap eared rabbits of either gender weighing from 2.5 to 3.0 kg were provided by the Experi mental Animal Center of Daping Hospital Affiliated to the Third Military Medical Univeristy of Chinese PLA.All the rabbits were divided randomly into normal con trol group(n=5),firearms injury group(n=30) and cutting injury group(n=30).The t wo latter groups were subdivided into one day, three day, one week, two week , 4 week and twelve week groups with 5 rabbits in each group. METHODS:The rabbits in the firearms injury group were injured at the midpoint of lateral posterior body surface projection of the right sciatic nerve with 0.3 8 g steel ball containing 0.65 g detonators.The right sciatic nerve was cut at t he same injury level in the cutting injury group. MAIN OUTCOME MEASURES:The following pathologic changes of the lumbar spinal co rd were observed with optical and electronic microscope at posttraumatic day 1,d ay 3 and week 1,week 2,week 4 and week 12 respectively. RESULTS:Micro hemorrhage,neuron swelling and vacuoles were observed in the fi rearms injury group and the number of motor neurons decreased significantly,but these changes were unobservable in the cutting injury group. CONCLUSION:Compared with the cutting group, the injury to the spinal cord was severer in the firearms group and the survival neurons were less.