膝关节腔内注射皮质类固醇对骨髓腔内压的影响

Changes of Intra bone marrow Pressures Induced by Intra articular Injection of Corticosteroid

３０只健康新西兰白兔，随机分为Ａ、Ｂ两组，每组１５只。Ａ组右膝关节内注射醋酸强的松龙７．５ｍｇ／ｋｇ，每周１次；Ｂ组右膝关节内注射生理盐水０．３７５ｍｌ／ｋｇ，每周１次，每组分别于第３、５、７、９、１１周的第１天，各取３只动物，在氯胺酮麻醉下，行双侧胫骨上端、股骨下端和膝关节腔穿刺，并测定腔内压力。结果：Ａ组用药２次后，骨髓腔内压明显高于Ｂ组，且随用药次数的增加而升高，用药１０次后，胫骨内压比Ｂ组高出２倍（３５ｃｍＨ２Ｏ比１１ｃｍＨ２Ｏ）。Ｂ组在整个实验期间均无明显改变。结论：关节内注射皮质类固醇可造成骨髓腔内压升高。提示，关节内注射皮质类固醇应慎重，必要时应减少用量和延长间隔时间。

The 177th PLA Hospital Thirty healthy New Zealand white rabbites were allocated into two groups (Group A.B),15 for each.(1) Group A:The right knee joint was injected with pnedniseione acetate in a dose of 7 5mg/kg per week;(2)Group B:Normal saline was injected instead of pnedniselone acetate as a control.Intra bone marrow pressure of bilateral lower segment of femoral bones,knee joint cavity and upper segment of tibiae was taken from three rabbits of each group at the times of 3rd,5th,7th,9th and 11th week during the experimental process.Result:In Group A;lntra bone marrow pressures were significantly increased after the 2nd injection.The pressure was 2 times as nigh as the control after the 10th injection(35vs.11cmH 2O).In Group B;intra bone marrow pressure was not changed during experimental period.Conclussion:Intra bone marrow pressure is significantly increased after intra articular injection of corticosterold.Care should be taken not to use corticosteroid intra articul in large dose and frequent injection in the treatment of osteo articular pain.