【摘要】：脊髓造影在臨床醫(yī)學(xué)中已是一項(xiàng)非常成熟的檢查技術(shù),在獸醫(yī)臨床檢查中的應(yīng)用在國(guó)外開展較早,各項(xiàng)操作及技術(shù)規(guī)范較為完善。而在我國(guó),能夠查閱到的中文文獻(xiàn)多為犬的脊髓造影,國(guó)內(nèi)有相關(guān)技術(shù)設(shè)備的少數(shù)大型動(dòng)物醫(yī)院,操作較多的也是犬的脊髓造影。在貓,國(guó)內(nèi)文獻(xiàn)中能夠查詢到的相關(guān)研究與臨床應(yīng)用的案例少之又少�；谖覈�(guó)基層獸醫(yī)教育層次的問題,很多一線獸醫(yī)難以從國(guó)外文獻(xiàn)中學(xué)習(xí)相關(guān)知識(shí);同時(shí),我國(guó)家貓的數(shù)量在不斷增加,因墜落、車禍等意外事故造成的脊椎損傷病例也呈增長(zhǎng)趨勢(shì)。故而將貓脊髓造影的操作流程及對(duì)比劑的使用劑量標(biāo)準(zhǔn)化、精細(xì)化將會(huì)為廣大一線獸醫(yī)的檢查操作帶來很多便利;并且能夠方便的根據(jù)具體病情選擇和確定對(duì)比劑的種類及規(guī)格,從而避免因?qū)Ρ葎┯昧坎蛔阍斐傻穆┰\、誤診或者因用量過大而造成的資源浪費(fèi)、神經(jīng)損傷或其它可能出現(xiàn)的不良反應(yīng)。對(duì)于神經(jīng)系統(tǒng)的檢查,現(xiàn)今醫(yī)學(xué)已有較為成熟的設(shè)備與技術(shù),如CT、MRI等。但是限于我國(guó)動(dòng)物醫(yī)院多屬于私人資產(chǎn),此類檢查設(shè)備多因成本高昂造成相應(yīng)檢查費(fèi)用超過多數(shù)人的消費(fèi)水平,從而導(dǎo)致此類設(shè)備在我國(guó)小動(dòng)物臨床診療中難以普及。所以脊髓造影技術(shù)在未來很長(zhǎng)一段時(shí)間內(nèi),仍將是獸醫(yī)臨床檢查中的一大支柱。甚至在人類醫(yī)學(xué)中,脊髓造影對(duì)于某些疾病的檢出優(yōu)于CT或MRI,這也是人類醫(yī)學(xué)保留脊髓造影技術(shù)至今的主要原因。本研究以健康家貓作為實(shí)驗(yàn)對(duì)象,以碘海醇和碘帕醇為實(shí)驗(yàn)藥物來確定脊髓造影時(shí)含碘對(duì)比劑在貓身上的使用劑量。實(shí)驗(yàn)的前半部分以碘海醇為對(duì)比劑,以20mgI/kg為分度值、30mgI/kg為起始劑量、270mgI/kg為最大劑量,設(shè)置13個(gè)實(shí)驗(yàn)劑量,通過分時(shí)攝片確定出最佳顯影效果的劑量以及最適顯影時(shí)間。本試驗(yàn)以腰椎間隙作為對(duì)比劑的注射部位,根據(jù)實(shí)驗(yàn)動(dòng)物的個(gè)體差異,注射點(diǎn)選定為L(zhǎng)5/6或L6/7,動(dòng)物采用俯臥位行腰椎穿刺術(shù),對(duì)比劑注射完畢后分別于第0min、5min、10min、20min、30min和60min攝取正(DV)、側(cè)(RL)位片。通過綜合對(duì)比分析發(fā)現(xiàn),全脊髓顯影的碘海醇用量為150mgI/kg,此劑量下藥物注射后10min即可全脊髓顯影,至60min椎管內(nèi)對(duì)比劑影像依然可辨。當(dāng)使用劑量為50mgI/kg時(shí),5min影像顯示腰椎段影像完整清晰,至20min腰椎段顯影模糊、可見胸椎段顯影,至60min腰椎段顯影不完全、胸椎段顯影尚可、頸椎段仍有顯影。準(zhǔn)確確定對(duì)比劑在貓脊髓造影中的使用計(jì)量在我國(guó)還是首次,本實(shí)驗(yàn)所確定的對(duì)比劑使用計(jì)量是以其中的碘含量以計(jì)算(即計(jì)量單位為mgI/kg),所以這一數(shù)據(jù)適用于同種藥物不同規(guī)格的產(chǎn)品以及其他多種規(guī)格的水溶性含碘對(duì)比劑。
[Abstract]:Myelography has been a very mature examination technology in clinical medicine. The application of myelography in veterinary clinical examination was carried out earlier in foreign countries, and the operation and technical specifications were more perfect. In our country, most of the Chinese literature can be found for dog myelography, and a small number of large animal hospitals with related technical equipment in China also operate more dog myelography. In cats, there are very few cases of related research and clinical application that can be queried in domestic literature. Based on the problem of grass-roots veterinary education in our country, it is difficult for first-line veterinary surgeons to learn relevant knowledge from foreign literature. At the same time, the number of cats in our country is increasing, and the cases of spinal injuries caused by falls, car accidents and other accidents are also on the rise. Therefore, standardizing the operation flow of myelography and the use of contrast agent in cats will bring a lot of convenience to the examination and operation of first-line veterinary surgeons, and can conveniently select and determine the types and specifications of contrast agent according to the specific condition, so as to avoid missed diagnosis, misdiagnosis or waste of resources caused by excessive dosage of contrast agent, nerve injury or other possible adverse reactions. For nervous system examination, medicine has more mature equipment and technology, such as CT,MRI and so on. However, limited to the fact that most animal hospitals in our country belong to private assets, most of this kind of examination equipment is more than the consumption level of most people because of the high cost, which makes it difficult to popularize this kind of equipment in the clinical diagnosis and treatment of small animals in our country. So myelography will remain a pillar of veterinary clinical examination for a long time to come. Even in human medicine, myelography is superior to CT or MRI, in the detection of some diseases, which is the main reason for the preservation of myelography in human medicine. In this study, healthy domestic cats were used as experimental objects, and iodohexol and iodophanol were used as experimental drugs to determine the dose of iodine contrast agent in cats during myelography. In the first half of the experiment, iodohexol was used as contrast agent, 20mgI/kg as the starting dose, 30mgI/kg as the initial dose and 270mgI/kg as the maximum dose. 13 experimental doses were set up. The best development effect dose and the optimum development time were determined by time-sharing film. In this experiment, the lumbar intervertebral space was used as the injection site of contrast agent. According to the individual difference of the experimental animals, the injection points were selected as L5 脳 6 or L6. The animals were treated with lumbar puncture in prone position. (RL) films on the (DV), side were taken at 0 min, 5 min, 10 min, 30 min and 60min respectively after injection of contrast agent. Through comprehensive comparative analysis, it was found that the dosage of iodinated alcohol in the whole spinal cord development was 150 mg I 鈮，

本文編號(hào)：2508502