乙醇治疗急性脊髓型减压病的实验研究

目的 观察乙醇治疗大白兔急性脊髓型减压病的疗效.方法 将58只新西兰大白兔分为乙醇组25只、生理盐水组20只和不采取任何治疗措施的对照组13只.将乙醇组15只、生理盐水组8只、对照组8只兔分别放入动物舱内,在15 min内用压缩空气加压至0.6 MPa,停留60 min,然后用5min匀速减压至常压出舱,制成急性脊髓型减压病模型.乙醇组出舱后30 min用25％乙醇溶液(3ml/ks),由耳缘静脉缓慢注射入血管；生理盐水组注射(3 ml/kg)生理盐水；对照组不作任何处理.所有兔均在造模前和出舱3d后行Tarlov法评估后肢运动、做MRI及测量脊髓诱发电位,随后处死,解剖,观察腹腔脏器并取胸腰段脊髓行HE染色和光镜检.结果 (1)Tarlov评分:乙醇组(4.31±0.63)分,生理盐水组( 1.25±0.50)分(与乙醇组比较,P＜0.01)；对照组(1.20±0.83)分(与乙醇组比较,P＜0.01).(2)MRI检查:乙醇组胸腰脊髓轻度肿胀,生理盐水组和对照组胸腰段脊髓肿胀,正常形态消失,并可见散在局灶性和弥漫性T2W高信号影.(3)SCEP检测:乙醇组的脊髓诱发电位N21潜伏期和波幅无明显变化,生理盐水组和对照组的脊髓诱发电位N21潜伏期较进舱前明显延长,差异有统计学意义(P＜0.01),波幅明显降低,差异有统计学意义(P＜0.01).(4)HE染色后,乙醇组光镜下仅见脊髓内少量散在出血及炎症细胞浸润；生理盐水组和对照组解剖可见尿潴留、肠胀气,光镜下可见脊髓弥漫出血、淤血、大量空泡及炎症细胞浸润.结论 乙醇有可能成为治疗急性脊髓型减压病的一种应急方法.

Experimental research on the therapeutic effect of alcohol on acute spinal cord decompression sickness in rabbits

Objective To investigate the therapeutic effect of alcohol on the treatment of acute spinal cord decompression sickness in rabbits.Methods Fifty-eight healthy New Zealand rabbits were randomly divided into 3 groups:the alcohol group ( group A,n =25 ),the saline solution group ( group B,n =20) and the control group ( group C,n =13).Rabbits in the animal chamber were pressurized with compressed air to a pressure of 0.6 MPa in 15 min,stayed at the said pressure for 60 min,then,were decompressed to atmospheric pressure with linear speed in 5 min.The model of acute spinal cord decompression sickness was successfully developed in 31 animals,of which 15 animals were in group A,8 animals in group B and another 8 animals in group C.The rabbits in group A were injected 25％ alcoholic solution (3 ml/kg) through the ear vein 30 min after decompression ; the animals in group B were treated with 3 ml/kg normal saline instead,while the rabbits in group C were left without any treatment.Spinal cord evoked potential (SCEP),magnetic resonance imaging (MRI) and Tarlov behavior scores were measured to assess motor neurologic function before compression and 3 days after decompression.All the animals were sacrificed,samples of spiral cord were taken from the animals of each group and HE staining was made for light microscopy.Results ( 1 ) Tarlov behavior scores:group A,4.31 ± 0.63 ; B group,1.25 ± 0.50 ( compared with group A,P ＜ 0.01 ) ; group C,1.20 ± 0.83 ( compared with group A,P ＜0.01 ).(2) MRI:animals in group A displayed mild swelling in thoracolumbar cord; animals in group B and C displayed moderate swelling,with normal morphology of spinal cord disappeared below the level of thoracolumbar cord and focal and diffuse hyper-intensity could be seen in the spinal cord on T2W images.(3) SCEP:for group A,no significant changes could be noted in the latency and amplitude of N21,3 days after decompression; for group B and group C,the latency of N21 delayed obviously 3 days after decompression,when it was compared with that before compression( P ＜ 0.01 ),and the amplitude of N21 also decreased obviously (P ＜0.01 ).(4) Group A:under the light microscope,HE staining revealed that there were only little sporadic hemorrhage and inflammatory infiltration in the spinal cord.Group B and group C:urine retention and intestinal tympanites could be observed,in addition,under the light microscope,local haemorrhage,extensive congestion and inflammatory cell infiltration could be observed in the spinal cord.Conclusions Alcohol treatment seemed to be a quick and effective method for the treatment of acute spinal cord decompression sickness.