脊髓损伤后并发肺损伤的实验研究

Experimental study on lung injury after spinal cord injury

目的探讨脊髓损伤后并发肺损伤的机理、病理及治疗方法。方法家兔40只,通过改良Allen法制成脊髓损伤模型,截瘫按Talove分级为1～2级,分为治疗组(B)和对照组(A),治疗组于伤后3h开始自静脉给予常规剂量(0.35mg/kg)的地塞米松治疗,分别于不同的时相点处死家兔,观察动物肺脏的病理改变。结果家兔脊髓损伤后均发生了不同程度的肺脏损伤,肺出血(100%)。脊髓损伤所致的肺出血,治疗组明显轻于对照组(P<0.01)。结论脊髓损伤均并发不同程度的肺损伤。肺损伤的发生机理主要是神经-体液应急反应。应用常规剂量的地塞米松即可以有效地预防和治疗脊髓损伤并发的肺损伤。

Objective To study the mechanism, pathology and treatment of the lung injury after spinal cord injury. Methods Models of spinal cord injury were made with modified Allen methods in 40 rabbits and divided into Group A (control group) and Group B (experimental group). Group B was treated with dexamethasone (0.35mg/k/d) by intravenous drip at first 3 days. The rabbits of spinal cord injury were killed for autopsy at different time points and their lungs were observed pathologically. Results Different degrees of lung injury, with hemorrhage of lung (100 %), occurred after spinal cord injury. The hemorrhage of lung in Group B which received the administration of dexamethasone was obviously slighter than that in Group A (P< 0.01). Conclusions Spinal cord injury may result in the lung injury. The mechanism of lung injury is mainly the emergency reaction by nerve and body fluids. Administration of dexamethasone in routine dosage may prevent and treat the lung injury after spinal cord injury.