本文選題：脊髓爆炸損傷 + 動物模型　； 參考：《第三軍醫(yī)大學》2015年碩士論文

【摘要】：對臨床醫(yī)生來講,脊髓損傷的救治一直充滿挑戰(zhàn)。脊髓損傷不僅給患者帶來巨大痛苦,而且也給社會福利造成嚴重影響。隨著局部戰(zhàn)爭、恐怖主義以及自殺性爆炸襲擊的增多,因爆炸導致的脊髓損傷患者也越來越多,因此脊髓爆炸損傷成為科學界關(guān)注的焦點。不幸的是目前關(guān)于脊髓爆炸傷的研究非常少,脊髓爆炸損傷的病理過程仍然不清楚,并且關(guān)于脊髓爆炸損傷的動物模型仍然很少,因此有必要建立一種動物脊髓爆炸損傷模型,不僅可以更好理解脊髓損傷后的病理過程同時也為臨床治療提供了一種新的脊髓損傷研究模型。目的：第一,建立一種可靠、穩(wěn)定的大鼠脊髓爆炸損傷模型裝置,在所建立的裝置基礎(chǔ)上利用紙質(zhì)電雷管爆炸產(chǎn)生沖擊波,模擬沖擊波導致的脊髓損傷。第二,建立大鼠不同程度的脊髓爆炸損傷。第三,初步探討大鼠脊髓爆炸損傷的機制。方法：研發(fā)一種大鼠脊髓爆炸損傷裝置,利用800mg TNT作為爆炸源進行爆炸實驗。根據(jù)爆炸沖擊波特征將96只雄性SD大鼠(體重在250-300g之間)被隨機分為5組：其中4cm組(n=12只)、5cm組(n=26只)、7.5cm(n=26只)、10cm組(n=26只)和對照組(n=6只)進行試驗,通過測量不同爆炸距離下爆炸沖擊波的超壓峰值,觀察不同爆炸距離下大鼠的臨床表現(xiàn),行為學和組織病理學改變對模型進行評估。結(jié)果：(1)利用800mgTNT作為爆炸源時,5cm爆炸沖擊波超壓峰值為998.68KPa,7.5cm為682.54KPa,10cm為245.90KPa。(2)不同爆炸距離下大鼠出現(xiàn)不同程度的臨床癥狀,所有實驗組動物中均出現(xiàn)不同程度的呼吸暫停,其中5cm組和7.5cm組動物還出現(xiàn)肢體抽搐和鼻出血癥狀,距離越近動物的癥狀越重。(3)不同爆炸距離導致BBB評分差異顯著,其中5cm組所有動物均出現(xiàn)持久的截癱,盡管傷后7d,BBB評分僅為8-9分；7.5cm組傷后一天評分為12-13分,7d為21分；10cm組大鼠傷后1d評分已達21分。此外,和對照組相比,5cm組大鼠和7.5cm組大鼠在傷后3d均有不同程度的運動功能障礙,表現(xiàn)為同側(cè)前肢步長和運動速度顯著降低(P0.05),10cm組大鼠與對照組相比無統(tǒng)計學差異(P0.05)。(4)HE染色和Nissl's染色均發(fā)現(xiàn)不同爆炸距離導致了不同程度的脊髓損傷,所有實驗組的神經(jīng)元和尼氏體數(shù)量均顯著降低,爆炸7天后5cm組脊髓前角己無神經(jīng)元存活,7.5cm組神經(jīng)元數(shù)量明顯減少并出現(xiàn)壞死和凋亡現(xiàn)象。大鼠脊髓爆炸損傷后大鼠運動功能的改變與脊髓前角運動神經(jīng)元的減少直接相關(guān),爆炸距離越近,大鼠運動功能越差,脊髓前角運動神經(jīng)元的數(shù)量越少。值得注意的是,10cm組動物中,雖無臨床癥狀和運動功能障礙,但是脊髓前角神經(jīng)元形態(tài)仍然有改變,尼氏體數(shù)量仍然比對照組偏少。結(jié)論：(1)我們團隊建立的大鼠脊髓損傷模型可靠,重復(fù)性及穩(wěn)定性良好,并且克服了其他模型的一些缺點。(2)該裝置能夠模擬沖擊波產(chǎn)生并且我們成功建立了三種不同程度的脊髓爆炸損傷即5cm組、7.5cm組和10cm組。(3)我們的研究表明脊髓爆炸損傷后大鼠運動功能的改變與脊髓前角運動神經(jīng)元的減少直接相關(guān),前角運動神經(jīng)元的數(shù)量越少,運動功能的受損越重。
[Abstract]:The treatment of spinal cord injuries has been challenging for clinicians. Spinal cord injury not only brings great pain to the patients, but also has a serious impact on social welfare. With the increase of local wars, terrorism and suicide bombings, more and more patients with spinal cord injury caused by the explosion are damaged, so the spinal cord explosion damage is caused. Unfortunately, there are few studies on the spinal cord injury, and the pathological process of the spinal cord explosion is still unclear, and there are still few animal models about the injury of the spinal cord. Therefore, it is necessary to establish an animal model of the injury of the spinal cord, which can not only better understand the pathology of the spinal cord injury. The process also provides a new model for the study of spinal cord injury for clinical treatment. Objective: first, establish a reliable and stable model device for the spinal cord explosion injury in rats. On the basis of the established device, the shock wave produced by the explosion of the paper electric detonator is used to simulate the injury of the spinal cord caused by the shock wave. Second Third, preliminary study on the mechanism of spinal cord explosion injury in rats. Methods: developing a rat spinal cord explosion damage device, using 800mg TNT as an explosion source to carry out the explosion experiment. According to the Potter sign of explosion shock, 96 male SD rats (between 250-300g) were randomly divided into 5 groups: 4cm group (n=12 only), 5cm Group (n=26 only), 7.5cm (n=26), 10cm group (n=26 only) and control group (n=6 only) were tested by measuring the overpressure peak of explosion shock wave at different explosion distances and observing the clinical manifestations of rats at different explosive distances. The behavior and histopathological changes were evaluated. Results: (1) 5cm explosions when 800mgTNT was used as the source of explosion. The peak overpressure of the shock wave was 998.68KPa, 7.5cm was 682.54KPa, and 10cm was 245.90KPa. (2) with different levels of clinical symptoms. All the animals in the experimental group had different degrees of apnea, of which the animals in the 5cm group and the 7.5cm group also had the symptoms of limb spasm and nosebleed, and the closer the distance to the animals, the heavier the symptoms of the animals. (3 The difference of BBB score was significant in different explosions, among which all animals in group 5cm had persistent paraplegia, although the score of BBB after injury was only 8-9 points, the score of 7.5cm in group 7.5cm was 12-13, 7d was 21, and 1D score of group 10cm was 21. Moreover, compared with the control group, both 5cm group rats and 7.5cm rats were all 3D after injury. Different degrees of motor dysfunction showed a significant decrease in the pace and speed of the ipsilateral forelimb (P0.05). There was no statistical difference between the 10cm group and the control group (P0.05). (4) both HE staining and Nissl's staining found that different distances caused different degrees of spinal cord injury, and the number of neurons and Nissl body in all the experimental groups was significant. After 7 days of explosion, the spinal cord anterior horn of group 5cm had no neuron survival, and the number of neurons in group 7.5cm decreased obviously and appeared necrosis and apoptosis. The change of motor function in rats after the spinal cord explosion injury was directly related to the reduction of motor neurons in the anterior horn of the spinal cord, the closer the distance of the explosion, the worse the motor function of rats, the motion deity of the spinal anterior horn of the rat. It is worth noting that in the 10cm group, although there is no clinical symptoms and motor dysfunction, the neurons in the anterior horn of the spinal cord still change, and the number of Nissl body is still less than that of the control group. Conclusion: (1) the model of spinal cord injury established by our team is reliable, repeatable and stable, and overcame it. Some shortcomings of his model. (2) the device can simulate shock waves and we have successfully established three different levels of spinal cord explosion injury, group 5cm, 7.5cm and 10cm. (3) our study showed that the changes of motor function in rats after spinal cord explosion injury were directly related to the reduction of motor neurons in the anterior horn of the spinal cord. The less the number of the elements, the more the damage to the motor function.
【學位授予單位】：第三軍醫(yī)大學
【學位級別】：碩士
【學位授予年份】：2015
【分類號】：R651.2

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本文編號：2011925