CAJ | 학술논문

目的观察两种浓度的臭氧(O3)硬膜外注射对实验兔脊髓的CT和病理学变化,以评估臭氧对实验兔脊髓的氧化程度.方法 15只实验兔完全随机分为A、B和C3组.给予氯胺酮30 mg/kg肌肉注射麻醉后,取右侧卧位,常规消毒铺巾后于L4～L5间隙行硬膜外穿刺,向头端置入硬膜外导管3cm.硬膜外注射臭氧-氧气混合气体A组浓度50 μg/L5 ml,B组浓度30 μg/L 5 ml,C组作为空白对照.注射后2h行脊柱CT扫描.根据CT扫描结果分别取脊髓活检.结果 A、B两组的CT扫描结果显示,椎管内积气,范围从L1～L7节段,C组椎管内未见积气.与C组比较,大体标本L1～ L7节段的脊髓苍白,肿胀,包膜紧张.50倍和100倍光镜结果显示,注射点、L1节段、L7节段的脊髓切面可见细胞体积增大,呈透亮空泡状;部分神经元细胞核固缩,胞体缩小变形,胞质尼氏体消失;胶质细胞胞体肿大;炎性细胞围绕血管形成血管套.脊神经根切面可见胞体肿胀,空泡变性.L1节段以上、L7节段以下以及C组的脊髓和神经根病理未见异常.结论在硬膜外注射治疗剂量的臭氧可能会损伤神经系统,远期效果需要进一步观察.
목적 관찰량충농도적취양(O3)경막외주사대실험토척수적CT화병이학변화,이평고취양대실험토척수적양화정도.방법 15지실험토완전수궤분위A、B화C3조.급여록알동30 mg/kg기육주사마취후,취우측와위,상규소독포건후우L4～L5간극행경막외천자,향두단치입경막외도관3cm.경막외주사취양-양기혼합기체A조농도50 μg/L5 ml,B조농도30 μg/L 5 ml,C조작위공백대조.주사후2h행척주CT소묘.근거CT소묘결과분별취척수활검.결과 A、B량조적CT소묘결과현시,추관내적기,범위종L1～L7절단,C조추관내미견적기.여C조비교,대체표본L1～ L7절단적척수창백,종창,포막긴장.50배화100배광경결과현시,주사점、L1절단、L7절단적척수절면가견세포체적증대,정투량공포상;부분신경원세포핵고축,포체축소변형,포질니씨체소실;효질세포포체종대;염성세포위요혈관형성혈관투.척신경근절면가견포체종창,공포변성.L1절단이상、L7절단이하이급C조적척수화신경근병리미견이상.결론 재경막외주사치료제량적취양가능회손상신경계통,원기효과수요진일보관찰.
Objective To observe the changes in CT image and pathological findings of spinal cord in experimental rabbits after epidural injection of two concentrations of ozone (O3),and to evaluate the level of ozone-induced oxidation in the spinal cord of experimental rabbits.Methods Fifteen experimental rabbits were randomized into three groups (groups A,B and C).All the rabbits were given intramuscular ketamine (30 mg/kg),then placed in right lateral positions,sterilized and draped,and cephalad catheterized (3 cm)after L4 ～ L5 epidural puncture.Groups A and B received epidural injection of 5 ml mixed O3-O2 (O3 concentrations:50 mg/L in group A and 30 mg/L in group B),while group C was set as the blank control group.Spinal CT scan was performed 2 hours after O3 injection,and then the rabbits were executed.Spinal cords were harvested for biopsies according to CT findings,and compared with the normal spinal cords from Group C.Results CT findings in both Groups A and B indicated intraspinal pneumatosis from L1 to L7,which was not found in Group C.Compared to Group C,the macroscopy of L1-L7 segments from groups A and B showed a pale,turgid swelling appearance with tensional envelope.In sections of spinal medullae at injection site,L1 and L7 segments,×50 or × 100 light microscopy showed transparent,cavity-like and swelling cells,karyopyknosis,contracted and deformed cell body,and in certain neurons,disappearance of cytoplasmal Nissl body,swelling body of gliocytes,perivascular cuffing of inflammatory cells; swelling,cavity-like and degenerated cell bodies were found in sections of spinal nerve roots.No abnormality was found in segments above L1 or below L7 or in the spinal cord from Group C.Conclusion Epidural injection of ozone at therapeutic dosage may lead to damage in neural system,although the long-term effect requires further observation.