【摘要】：目的:研究早期與延遲減壓對大鼠脊髓急性損傷并壓迫模型的神經(jīng)功能影響,探討不同減壓時間對脊髓損傷后神經(jīng)功能恢復有無差異,為臨床脊髓急性損傷手術減壓時限的選擇提供實驗依據(jù)和理論基礎。方法:健康SD雌性大鼠68只,重量250-300g,隨機分成四組:只行椎板切除無脊髓損傷對照A組(n=8)、脊髓撞擊傷并壓迫后6小時減壓B組(n=20)、脊髓撞擊傷并壓迫后48小時減壓C組(n=20)、脊髓撞擊傷并持續(xù)壓迫D組(n=20)。每組又按照手術后時間隨機平均分為術后1d、7d、14d和28d四個小組(n=5),每只大鼠術前術后行BBB評分,然后取出損傷節(jié)段脊髓組織檢測神經(jīng)中絲蛋白(NF)化學活性的變化,TUNEL檢測細胞凋亡,HE染色觀察脊髓組織學變化。結(jié)果:1、BBB評分:SD大鼠造模后及減壓術后1d,BBB評分約為2分,各組間無統(tǒng)計學差異(P0.05);術后7、14、28d各組大鼠BBB評分均明顯低于A組,有明顯統(tǒng)計學差異(P0.05),B組的BBB評分最高,D組的BBB評分最低。2、組織學觀察結(jié)果2.1肉眼觀察:造模后脊髓早期有充血水腫、中間凹陷。經(jīng)減壓后損傷脊髓矢狀徑恢復。2.2蘇木精一伊紅(HE)染色:A組脊髓無損傷;D組脊髓損傷程度最為明顯,組織結(jié)構(gòu)紊亂,損傷部位有明顯空腔,周圍瘢痕形成;B組損傷程度較C組小,損傷區(qū)脊髓無空洞,無明顯瘢痕,與周圍無明顯界限;C組脊髓損傷區(qū)可見少量空泡細胞,周圍有瘢痕形成。3、細胞凋亡T U N E L染色結(jié)果:A組幾乎沒有陽性細胞,其他各組損傷周圍均可見較多陽性細胞,分布不均勻。B組術后脊髓TUNEL陽性細胞數(shù)在7d時最多,C、D組隨著時間延長,陽性細胞數(shù)逐步減少,28 d后仍可見凋亡細胞。減壓后相同時間內(nèi)B組陽性細胞數(shù)較其他兩組陽性細胞數(shù)明顯減少,并且D組陽性細胞數(shù)最多,有明顯統(tǒng)計學差異(P0.05)。4、免疫熒光染色:A組中見極少量NF-200陽性細胞。其余各組中隨著時間的延長,NF陽性細胞數(shù)逐步增加,平均吸光度增強。術后1d B、C、D三組之間無統(tǒng)計學意義。術后7、14、28d,B組中NF-200的表達最高,D組陽性細胞數(shù)最少,差異有統(tǒng)計學意義(P0.05)。結(jié)論:1、手術減壓對大鼠脊髓急性損傷并壓迫模型的神經(jīng)功能恢復具有促進作用。2、早期手術減壓相對晚期手術減壓神經(jīng)功能恢復更為明顯。
[Abstract]:Objective: to study the effects of early decompression and delayed decompression on the neural function of rats with acute spinal cord injury and compression, and to explore whether different decompression time has different effects on the recovery of nerve function after spinal cord injury. To provide experimental and theoretical basis for the selection of decompression time limit for clinical acute spinal cord injury. Methods: Sixty-eight healthy SD female rats, weighing 250-300g, were randomly divided into four groups: control group A (n = 8) treated with laminectomy only and decompression group B (n = 20) 6 hours after spinal cord impact injury and compression. Spinal cord impact injury and compression were performed 48 hours after decompression in group C (n = 20), spinal cord impact injury combined with continuous compression (n = 20). Each group was randomly divided into four groups according to the time of operation, one day, seven days, fourteen days and 28 days after operation. Each rat was given BBB score before and after operation, and then the changes of (NF) chemical activity of filaments in nerve were detected by taking out the injured spinal cord tissue. Apoptosis was detected by TUNEL and histological changes of spinal cord were observed by HE staining. Results: 1BBB score: the BBB score of SD rats was about 2 after modeling and 1 day after decompression (P0.05). The BBB scores of rats in each group were significantly lower than those in group A on the 7th day and 28th day after operation (P0.05). The BBB score of group), B was the highest, the BBB score of group D was the lowest (P0.05), and the BBB score of group D was the lowest (P < 0.05). Results of histological observation 2.1 observation with naked eyes: there were hyperemia and edema in the early stage of spinal cord. The sagittal diameter of the injured spinal cord recovered after decompression. 2.2 hematoxylin-eosin (HE) staining showed that there was no spinal cord injury in group A, the degree of spinal cord injury in group D was the most obvious, the tissue structure was disordered, the site of injury was obviously empty and the scar formed around the spinal cord. The degree of injury in group B was smaller than that in group C, and there was no syringomyelia and scar in the injured area. In group C, a small number of vacuole cells were found in the injured area of spinal cord, and scar formation was found around them. The results of T U N E L staining showed that there were almost no positive cells in group A, and more positive cells were found in all the other groups. The number of TUNEL positive cells in the spinal cord of group B was the highest at 7 days after operation, and the number of positive cells in group D decreased gradually with time, and the apoptotic cells were still seen 28 days later. At the same time after decompression, the number of positive cells in group B was significantly lower than that in the other two groups, and the number of positive cells in group D was the most (P0.05). Immunofluorescence staining: a very small number of NF-200 positive cells were found in group A. In other groups, the number of NF positive cells increased gradually and the average absorbance increased with time. There was no significant difference among the three groups on the 1st day after operation. The expression of NF-200 in group B was the highest, and the number of positive cells in group D was the least (P0.05). Conclusion: 1. Surgical decompression can promote the recovery of neural function in the model of spinal cord injury and compression. 2. The recovery of nerve function in early decompression is more obvious than that in late stage.
【學位授予單位】：南昌大學
【學位級別】：碩士
【學位授予年份】：2015
【分類號】：R651.2

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