牵张性脊髓损伤脊髓SCEP监护作用的实验研究

Experimental study of SCEP in spinal cord monitoring for the traction injury of the spinal cord/MAO Fangmin

目的：探讨脊髓皮层诱发电位对牵张性脊髓损伤的监护作用。方法：选用４０只健康大白兔，随机分成对照组（Ａ组）、体感皮层诱发电位（ＳＣＥＰ）波幅下降３０％组（Ｂ组）、ＳＣＥＰ波幅下降５０％５ｍｉｎ组（Ｃ组）和１０ｍｉｎ组（Ｄ组）。通过对脊髓ＳＣＥＰ监测、动物脊髓功能评定、组织形态学观察以及脊髓微血管铸型扫描电镜观察来研究牵张性脊髓损伤。结果：随着牵开负荷增大和作用时间的延长，脊髓微血管发生充盈缺损、痉挛直至破裂出血；Ｃ组及Ｄ组脊髓功能下降，与Ａ组相比有显著性差异。结论：ＳＣＥＰ波幅变化能较客观地反映脊髓功能状况。

Objective\ To explore the monitoring function of somatosensory cortical evoked potential for the traction injury of spinal cord.Method:The traction of the spine was performed on forty rabbits according to the amplitude of P1 wave and the amount of decreasing of the P1 control 30% for 10 minutes,50% for 5 minutes and 50% for 10 mintues respectively in the experimental groups.During traction,the spinal cord was monitoring by SCEP.The function of spinal cord and the patho morphological changes were observed.At the same time the path morphological changes of spinal cord were observed with scanning electronic microscopy by microerosion cast.Result:The microvessels of spinal cord would spasm and break during the traction of the spine.The function of the 50% 5 minutes groups and the 50% 10mintues group decreased,they had marked difference with that of the control group.Conclusion:The changes of amplitude of SCEP could reflect the function of spinal cord objectively.A 50% decreasing in amplitude for more than 10 mintues would lead to an irreversible deficit. Authors address\ Orthopedics Department of 2nd Affiliated Hospital of Wenzhou Medical College,Zhejiang,325027