【摘要】：目的觀察等容血液稀釋產(chǎn)生的脊髓體感誘發(fā)電位、運(yùn)動(dòng)誘發(fā)電位變化及脊髓功能的變化，探討圍術(shù)期血液稀釋對(duì)脊髓功能的影響。 方法健康雄性SD大鼠20只，體重359±5.12g，血紅蛋白144±13.5g/l,隨機(jī)分成兩組(n=10只)：血液稀釋組（A組），對(duì)照組（B組），進(jìn)行BBB脊髓運(yùn)動(dòng)功能評(píng)分，頸內(nèi)靜脈置管。一周后A組采用6%羥乙基淀粉進(jìn)行血液稀釋處理，同時(shí)監(jiān)測(cè)心率、血壓、血紅蛋白變化、體感誘發(fā)電位（SSEP）的波幅、潛伏期、形態(tài)變化、運(yùn)動(dòng)誘發(fā)電位（MEPs）形態(tài)變化，直至血紅蛋白到達(dá)50±5g/L目標(biāo),三小時(shí)后再次進(jìn)行脊髓BBB運(yùn)動(dòng)功能評(píng)分，再次麻醉灌注固定取脊髓HE染色，光鏡下觀察形態(tài)學(xué)變化。B組監(jiān)測(cè)與A組相同時(shí)點(diǎn)分別為實(shí)驗(yàn)前、無處理等待40分鐘后，三小時(shí)后測(cè)脊髓BBB運(yùn)動(dòng)功能評(píng)分，進(jìn)行麻醉后灌注固定取脊髓HE染色進(jìn)行光鏡檢查。所得數(shù)據(jù)進(jìn)行相關(guān)統(tǒng)計(jì)學(xué)檢驗(yàn)分析。 結(jié)果A組大鼠血液稀釋前后比較，血紅蛋白水平降低差別有統(tǒng)計(jì)學(xué)意義（P0.05），體感誘發(fā)電位潛伏期延長，有統(tǒng)計(jì)學(xué)意義（P=0.002, P0.05）；波幅降低，無統(tǒng)計(jì)學(xué)意義（P=0.734, P0.05）；組內(nèi)比較運(yùn)動(dòng)誘發(fā)電位實(shí)驗(yàn)前后差別有統(tǒng)計(jì)學(xué)意義（P0.05）。B組組內(nèi)比較實(shí)驗(yàn)前后血紅蛋白、SSEP、MEPs差別均無統(tǒng)計(jì)學(xué)意義（P0.05）。A組與B組相比，血液稀釋后３小時(shí)BBB運(yùn)動(dòng)行為學(xué)評(píng)分無差別（P0.05），取脊髓HE染色光鏡檢查，，神經(jīng)細(xì)胞核形態(tài)無差別。 結(jié)論血液稀釋引起的血紅蛋白下降，對(duì)脊髓神經(jīng)功能的傳導(dǎo)將產(chǎn)生影響，臨床對(duì)于脊髓相關(guān)手術(shù)保持良好的血紅蛋白水平有益于脊髓傳導(dǎo)功能的維護(hù)。
[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 鹵5.12 g, hemoglobin 144 鹵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 鹵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.
【學(xué)位授予單位】：福建醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2014
【分類號(hào)】：R614

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