硬膜外腔注射皮质类固醇不能防治硬膜外腔粘连

Effects of epidural corticosteroids on occurrance of epidural adhesion in sheep

目的 观察动物长期硬膜外腔置管并注射皮质类固醇对硬膜外腔的影响。方法 绵羊2 0只 ,随机分成两组 ,每组 10只 ,A组为实验组 ,经留置硬膜外导管每周 1次注入地塞米松 4 m g及1%利多卡因 8ml,并在每次给药后观察麻醉起效时间、扩散范围和运动阻滞情况 ;B组为对照组 ,每周 1次注入 1%利多卡因 8ml。每组分别于第 3、5、7、9、11周的每 1天各取 2只动物进行硬膜外腔造影 ,随后处死取硬膜及硬膜外组织做组织学检查。结果 随着硬膜外腔置管时间延长 ,麻醉阻滞范围变窄 ,麻醉阻滞时间也明显缩短 ,两组之间没有明显区别 ;硬膜外腔造影显示 :造影剂在硬膜外腔扩散良好 ,无明显受阻 ;组织学检查显示 :置管时间长 ( 4周以上 )的动物 ,硬膜外组织炎细胞浸润、纤维组织增生、硬膜增厚 ,而且随置管时间延长 ,这种变化更加显著 ,但两组之间没有明显区别。

Objective To observe the effects of epidural corticosteroids on epidural adhesion induced with long term epidural catheter placement.Methods Twenty sheeps were classified into A and B groups(either group with 10 animals).In group A,epidural injection was administered once per week with dexamethasone 4mg and 1% lidocaine 8ml.In group B(control),epidural injection was made once per week with 1% lidocaine.The anesthetic onset,range and degree were observed in the two groups.Furthermore,the roentgenography of epidural space and biopsy of epidural tissues were made on two animals each time in either group 3,5,7,9 and 11 weeks after the beginning of observa tion.Results The anesthesia range was narrowed and anesthesia duration was shortened with the prolongation of epidural catheter placement,Epidural roentgenography showed that the medium dif fused normally within epidural space,biopsy of epidural tissues showed that there were inflammative cells infiltration and fiber proliferation with longer epidural catheter placement(more than 4 weeks),without significant differences between both groups.Conclusion Epidural corticosteroids can not prevent epidural adhesion from occurrance induced with long term epidural catheter placement