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目的观察鞘内间断注射不同浓度罗哌卡因对大鼠脊髓、神经根早期超微结构的影响。方法雄性SD大鼠24只,按改良Yaksh法置入导管至脊髓腰段鞘内8 cm。随机分为4组(n=6):N 组(对照组)经导管注入0.9%氯化钠40μl,每1.5 h一次,共3次。R1、R2、R3注药方式同N组,分别注入0.5%、0.75%、1%罗哌卡因40μl。各组在注药后6 h取腰膨大处1mm3脊髓及神经根,电镜下观察其早期超微结构变化。结果N、R1、R2组脊髓、神经根早期超微结构基本正常。R3组大多数神经元细胞固缩,大多数粗面内质网扩张,线粒体及内质网结构模糊,有少数神经元细胞完全变性;部分有髓神经纤维变性,板层结构疏松;雪旺氏细胞固缩。与R3组比较,N、R1、R2组神经元胞质空泡形成或变性评分、灰质内空泡评分、髓鞘丢失断裂评分、内、外轴膜清晰度评分及神经根空泡变性评分均降低(P<0.05),而灰质内出血评分差异无统计学意义(P>0.05)。N、R1、R2组间以上评分比较差异无统计学意义(P>0.05)。结论0.5、0.7%罗哌卡因间断鞘内注射对大鼠脊髓、神经根超微结构无明显影响,1%罗哌卡因则可造成脊髓损害。
Objective To observe the effects of intermittent intrathecal injection of ropivacaine on the ultrastructure of spinal cord and nerve root in rats. Methods Twenty-four male Sprague-Dawley rats were implanted 8 cm into the lumbar spinal cord of the spinal cord according to the modified Yaksh method. They were randomly divided into 4 groups (n = 6): N group (control group) were injected with 40μl of 0.9% sodium chloride via catheter, once every 1.5 hours for 3 times. R1, R2, R3 injection method with the N group were injected 0.5%, 0.75%, 1% ropivacaine 40μl. The rats in each group received 1mm3 spinal cord and nerve root lumbar enlargement at 6 hours after injection, and their ultrastructural changes were observed under electron microscope. Results N, R1, R2 group of spinal cord, nerve root ultrastructure early normal. In most of the neurons in group R3, the majority of neurons were pyknotic, most of the rough endoplasmic reticulum was dilated, the structure of mitochondria and endoplasmic reticulum was vague, and a few neurons were completely degenerated. Some myelinated nerve fibers degenerated and the lamellar structure was loosened. Cell shrinkage. Compared with group R3, the scores of formation and degeneration of neuronal cytoplasm vacuolus, vacuoles in gray matter, loss of remyelination, scores of medial and lateral axial membrane degeneration and nerve root vacuolar degeneration in N, R1 and R2 groups (P <0.05), while there was no significant difference in intracranial hemorrhage score (P> 0.05). N, R1, R2 scores between the above groups showed no significant difference (P> 0.05). Conclusion 0.5,0.7% intermittent intrathecal injection of ropivacaine has no significant effect on the ultrastructure of spinal cord and nerve root in rats, while 1% ropivacaine can cause spinal cord injury.