体感皮层诱发电位对牵张性脊髓损伤的监护作用

Monitoring Effect of Somatosensory Cortical Evoked Potential on Tractive Spinal Cord Injury in Rabbits

目的探索体感皮层诱发电位（ＳＣＥＰ）对牵张性脊髓损伤的监护作用。方法采用４０只日本大耳白兔，随机分为对照组、ＳＣＥＰＰ１波下降３０％组、５０％持续５分钟组、５０％持续１０分钟组。通过对实验动物进行运动功能评价、生化指标测定及组织形态学观察，研究ＳＣＥＰ对牵张性脊髓损伤监护的可靠性。结果ＳＣＥＰＰ１波幅随脊柱撑开程度增加而下降，动物后肢运动功能障碍率明显增大，５０％组可见脊髓内血管痉挛，狭窄及破裂出血。结论（１）ＳＣＥＰ的Ｐ１、Ｎ１波幅变化较其潜伏期的变化更能准确地反映脊髓功能的改变。（２）Ｐ１波幅下降３０％无脊髓功能损害。（３）Ｐ１波幅下降５０％，５分钟内除掉撑开作用，所产生的轻度脊髓功能障碍可在短期内恢复；如撑开时间超过５分钟，将产生不可逆的脊髓功能损害。

Aim To explore the monitoring effect of the somatosensory cortical evoked potential (SCEP) on the tractive spinal cord injury. Methods Forty rabbits were randomly divided into four groups according to the amount of decreasing amplitude of SCEP P 1 wave: zero as the contral group, 30% for 10 minutes group, 50% for 5 minutes group, and 50% for 10 minutes group. The function of the spinal cord was assessed, the amount of MDA and SOD of the spinal cord tissue was determined, and the pathomorphological changes of the spinal cord were observed. Results The more the P 1 wave amplitude decreased, the more the spine was distracted. The rate of Tarlov and Molt deficits increased, and spasm, stenosis and bleeding of the vessel in spinal cord could be found. Conclusions (1) The changes of SCEP P1 wave can reflect the function of spinal cord more objectively than that in the latency. (2) When there was a reduction of 30% in amplitude of P1 wave, the function of spinal cord was normal. (3) When there was a 50% decreasing in amplitude for 5 minutes, a mild dysfunction of spinal cord can recover in short time. But 50% decreasing in amplitude for 10 minutes will lead to an irreversible function deficits of the spinal cord.