脊髓爆震伤后早期脊髓前角运动神经元的形态学变化_医学论文.docVIP

脊髓爆震伤后早期脊髓前角运动神经元的形态学变化_医学论文 脊髓爆震伤后早期脊髓前角运动神经元的形态学变化_医学论文 作者：于杰，罗卓荆，张雪非，徐新智，吕荣，陈良为，耿丹 【关键词】 ,脊髓损伤 Early morphological changes of anterior horn motor neurons after explosive injury of spinal cord 　　【Abstract】 AIM: To establish an animal model with explosive injury of spinal cord, and to explore the early morphological changes of anterior horn motor neurons after explosive injury of spinal cord. METHODS: Thirtysix rabbits were randomly divided into control group （Group A, n=12）， 6 h experimental group (Group B, n=12) and 24 h experimental group (Group C, n=12). Group B and C were injured with 0.9 g cyclotrimethylene trinitramine, and 6 h and 24 h after trauma, the injured spinal cords were taken for observation of the morphological changes and apoptosis of spinal motor neurons using HE staining， toluidine blue staining and Cajal staining under light microscopes. RESULTS: The reversible change of the neurons of the rabbits happened after 6 h， and some neurons was observed dead，the mean of the death being 12.58±2.23； 24 h after trauma， a great quantity of neurons were observed dead， the mean of the death being 31.52±2.69, which differed significantly from that in the control group (0.01). CONCLUSION: Most of the damage is reversible within 6 h after trauma，therefore the early discovery and treatment should be emphasized. 　　【Keywords】 spinal cord injury blast injuries spinal cord neuron morphology 　　【摘要】 目的：建立脊髓爆震伤动物实验模型，探讨脊髓爆震伤后早期脊髓前角运动神经元形态学变化. 方法：将36只家兔随机分为对照组(A组,n=12) ，6 h实验组(B组,n=12)及24 h实验组(C组,n=12)，采用0.9 g单质金属炸药黑索金（RDX）将B,C组家兔炸伤，分别于伤后6 h及24 h两个时间点取材，进行HE染色、甲苯胺蓝染色及银浸染色，观察脊髓神经元形态学改变. 结果：脊髓爆震伤后6 h脊髓运动神经元发生可逆性改变，部分神经元坏死，死亡均数为12.58±2.23，而伤后24 h脊髓运动神经元大量坏死，死亡均数达到了31.52±2.69，与对照组相比差异有统计学意义（0.01）. 结论：脊髓爆震伤后6 h内脊髓运动神经元以可逆性改变为主，提出早期发现和治疗的重要性. 　　【关键词】 脊髓损伤；爆震伤；脊髓；神经元；形态学 　　0引言 　　在近、现代战争中脊柱、脊髓火器伤的发生率约占到所有战伤的0.3％～4．6％，而其中约有78％是爆炸性武器造成的［1］，爆震伤已经成为战争中脊柱、脊髓损伤的主要原因. 脊柱、脊髓爆震伤的致残率高、后遗症多，因此它在战伤的救治中占有重要的地位. 由于目前国内、外有关这方面的研究报道较少，沿用多年的救治措施和理论已不能适应现代化战伤的救治工作. 脊髓爆震伤的发生机制与日常的急性脊髓损伤（acute