【摘要】 目的探讨正中神经F波对兔急性椎管狭窄导致脊髓压迫损伤的评估作用及对运动功能的预测价值。方法 20只新西兰大白兔用随机分组法分实验组(n=15)和对照组(n=5),实验组分为A、B和C三个亚组(n=5),分别在C6-C7椎板间隙向尾端方向植入直径为1.0 mm、1.5 mm和2.0 mm的实心硅胶柱,分别记录术前和术后波形平稳后的F波,麻醉前和术后2 d进行运动功能评分。对照组用于排除麻醉和手术对F波的影响。结果A、B和C组F波波幅和潜伏期均对椎管狭窄脊髓压迫损伤敏感,分别经过(0.36±0.17) min、(0.36±0.22)min和(0.32±0.13) min波变平稳;A、B和C组术后波形平稳后波幅与基线波幅百分比(71.93%±6.90%)、(34.74%±6.05%)和(8.32%±4.25%)经配对t检验,与本组术前基线波幅与基线波幅百分比(100.00%±0.00%)、(100.00%±0.00%)和(100.00%±0.00%)比较,差异有统计学意义(均P<0.05);A、B和C组手术后波形平稳后潜伏期(9.48±1.31)ms、(12.04±0.48)ms和(10.55±0.21) ms经配对t检验,与术前(8.48±0.76) ms、(9.08±0.91)ms和(8.45±0.71)ms比较,差异有统计学意义(均P<0.05);各组F波术后早期的波幅变化和术后2 d前肢运动功能评分经Spearman相关性分析呈显著性正相关(r=0.960, P<0.05)。结论兔正中神经F波对发现椎管狭窄引起的脊髓损伤非常敏感;早期F波的波幅变化可以预测脊髓损伤后的肢体运动功能。更多还原

【Abstract】 Objective To investigate role of the F-wave of median nerve in acute spinal stenosis spinal cord compression injury in rabbits and its predictive value for motor function. Methods Twenty New Zealand white rabbits were randomly divided into the experimental group(n=15) and the control group(n=5).The experimental group was divided into three subgroups: A, B and C(n=5), solid silica gel columns with diameters of 1 mm, 1.5 mm and 2 mm were implanted downward in the laminar space of C6-7 and the F-waves were recorded preoperative and postoperative in the experimental group after the waveform stabilization. Motor function scores were calculated before anesthesia and 2 days after operation. The control group A was used to excluded the effects of anesthetics and surgical procedures on F-wave.Results The amplitude and latency of F-waves in groups A, B and C were sensitive to spinal cord compression injury due to spinal stenosis. The waveform stabilization time was 0.36 ± 0.17 min,(0.36 ± 0.22 min and 0.32 ± 0.13 min in groups A, B and C, respectively. There were significant statistical differences between the percentage of postoperative amplitude after stabilization and the baseline amplitude(71.93%±6.90%, 34.74%±6.05% and 8.32%±4.25% in groups A, B and C, respectively)and the percentage of the baseline amplitude and baseline amplitude(100.00% ±0.00%, 100.00% ±0.00% and 100.00% ±0.00% in groups A, B and C, respectively) by paired t-test in groups A, B and C(all P <0.05);There were significant statistical differences between latency postoperative after stabilization(9.48±1.31 ms,12.04±0.48 ms and 10.55±0.21 ms in groups A, B and C) and latency preoperative(8.48 ±0.76 ms,9.08±0.91 ms and 8.45±0.71 ms in groups A, B and C) by paired t-test(all P<0.05).There was a significant positive correlation between the early change of F-wave amplitude and motor function scores of forelimb 2 days in each group after operation by speraman correlation analysis(r=0.960, P<0.05). Conclusion The F-wave of forelimbs in rabbits is very sensitive to spinal cord injury caused by spinal stenosis. The amplitude early change of F-wave can predict limb motor function after spinal cord injury in the acute phase.更多还原