硬膜外腔持续泵输注和推注伊索显时硬膜外腔的三维影像

TRIDIMENSIONAL IMAGE OF EPIDURAL SPACE FOLLOWING PUMP INFUSION AND BOLUS INJECTION OF DILUTED ISOVIST 300 INTO EPIDURAL SPACE

利用Ｘ－ＴＶ和ＣＴ扫描技术，我们研究了２０例男青年硬膜外腔的三维影像。病人随机分为泵输注组和单次推注组，分别以１ｍｌ／ｍｉｎ和１ｍｌ／３ｓ速度向硬膜外腔注入稀释的伊索显３００溶液８ｍｌ，连续观察和研究冠状面、矢状面和横断面上硬膜外腔的扩散和影像，结果进一步显示，两种不同方法给药，硬膜外腔的纵向扩散无明显差别。更重要的发现是硬膜外腔造影剂节段性充盈，后腔在椎体中部水平狭窄，椎间盘水平膨大；前腔在椎体中部水平膨大，有纵隔，在椎间盘水平消失。作者推论硬膜外腔是一个连续性非等腔径的结构，是随椎体节段呈竹节样分布。

The anatomy of epidural space was demonstrated by X-ray TV and CT during epidural continuous infusion and after bolus injection of diluted isovist 300 8ml the speeds of 1ml/min and 1ml/3s respectively in 20 patients undergoing lower abdominal or lower extremity surgery.There was no significant difference in longitudinal spread of the contrast in the epidural space between the 2 conditions, but the leakage of the contrast around the catheter and diffusion into the intervertibral foremina were more prominent in the bolus injection group.The important finding was the segmental filling pattern of the contrast in the different compartments of the epidural space,The filling showed the posterior compartment has its minimal dimensions at the middle portion of vertebral bodies and its maxi mal dimmensions at the level of discs.In contrast, the anterior compartment has its maximal dimensions at the middle portion of vertebral bodies and is absent at the level of discs.These features may be of importance for us to understand the local mechanics and pharmacokinetics of sulitions injected into the epidural space.