等容血液稀释对脊髓功能影响的实验研究

发布时间：2018-12-15 22:36

【摘要】：目的观察等容血液稀释产生的脊髓体感诱发电位、运动诱发电位变化及脊髓功能的变化，探讨围术期血液稀释对脊髓功能的影响。方法健康雄性SD大鼠20只，体重359±5.12g，血红蛋白144±13.5g/l,随机分成两组(n=10只)：血液稀释组（A组），对照组（B组），进行BBB脊髓运动功能评分，颈内静脉置管。一周后A组采用6%羟乙基淀粉进行血液稀释处理，同时监测心率、血压、血红蛋白变化、体感诱发电位（SSEP）的波幅、潜伏期、形态变化、运动诱发电位（MEPs）形态变化，直至血红蛋白到达50±5g/L目标,三小时后再次进行脊髓BBB运动功能评分，再次麻醉灌注固定取脊髓HE染色，光镜下观察形态学变化。B组监测与A组相同时点分别为实验前、无处理等待40分钟后，三小时后测脊髓BBB运动功能评分，进行麻醉后灌注固定取脊髓HE染色进行光镜检查。所得数据进行相关统计学检验分析。结果A组大鼠血液稀释前后比较，血红蛋白水平降低差别有统计学意义（P0.05），体感诱发电位潜伏期延长，有统计学意义（P=0.002, P0.05）；波幅降低，无统计学意义（P=0.734, P0.05）；组内比较运动诱发电位实验前后差别有统计学意义（P0.05）。B组组内比较实验前后血红蛋白、SSEP、MEPs差别均无统计学意义（P0.05）。A组与B组相比，血液稀释后３小时BBB运动行为学评分无差别（P0.05），取脊髓HE染色光镜检查，，神经细胞核形态无差别。结论血液稀释引起的血红蛋白下降，对脊髓神经功能的传导将产生影响，临床对于脊髓相关手术保持良好的血红蛋白水平有益于脊髓传导功能的维护。
[Abstract]:Objective to observe the changes of somatosensory evoked potential, motor evoked potential and spinal cord function induced by isovolemic hemodilution, and to investigate the effect of hemodilution on spinal cord function during perioperative period. Methods Twenty healthy male SD rats, weight 359 卤5.12 g, hemoglobin 144 卤13.5 g / l, were randomly divided into two groups (n = 10): hemodilution group (group A) and control group (group B). BBB spinal cord motor function score and internal jugular vein catheterization were performed. One week later, group A was treated with 6% hydroxyethyl starch for hemodilution. Heart rate, blood pressure, hemoglobin, amplitude, latency, morphology and (MEPs) of somatosensory evoked potential (SSEP) were monitored. Until hemoglobin reached the target of 50 卤5g/L, the motor function of spinal cord BBB was scored again three hours later, the spinal cord HE staining was fixed with anesthesia perfusion again, and the morphological changes were observed under light microscope. After no treatment for 40 minutes, the spinal cord BBB motor function score was measured three hours later, and the spinal cord HE staining was performed after anesthesia. The data were analyzed by correlation statistical test. Results before and after hemodilution in group A, the hemoglobin level decreased significantly (P0.05), the latency of somatosensory evoked potential (SEP) was prolonged (P0. 002, P0.05). The amplitude decreased without statistical significance (P0. 734, P0.05). There was significant difference before and after motor evoked potential test (P0.05) hemoglobin and SSEP,MEPs in). B group were not statistically significant (P0.05 compared with B group, P0.05). A group, P 0.05, P < 0.05). 3 hours after hemodilution, there was no difference in BBB motor behavior score (P0.05). Light microscopic examination of spinal cord HE staining showed that there was no difference in nuclear morphology of nerve cells. Conclusion the decrease of hemoglobin induced by hemodilution will have an effect on the conduction of spinal cord nerve function. It is beneficial to maintain the conduction function of spinal cord by maintaining a good hemoglobin level for spinal cord surgery.
【学位授予单位】：福建医科大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R614

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