硬膜外腔化学性神经根毁损镇痛的安全性研究

THE SAFETY OF EPIDURAL INJECTION WITH CHEMICAL NEUROLYTIC DRUGS

摘要:

目的：研究无水乙醇和酚甘油椎管内硬膜外腔注射进行化学性神经根毁损的安全性。方法：日本大耳白兔42只，随机分为7组，分别在下腰段和中胸段水平硬膜外腔注射无水乙醇、7．5％和15％酚甘油。观察实验兔行为、后肢肌力变化、硬膜外腔再次置管引起出血的机会和椎管内软组织病理变化。结果：下腰段硬膜外腔注射无水乙醇或酚甘油引起实验兔近期不同程度后肢瘫痪、大便失禁和尿潴留，不给予特殊护理时2周内病死率达72％。中胸段硬膜外腔注射对实验兔行为和大、小便功能影响不明显。三月后再次硬膜外腔置管不引起腔内异常出血，软组织病理检查显示无预示容易出血的改变。结论：硬膜外腔注射无水乙醇和酚甘油进行化学性神经根毁损对实验兔运动神经和植物神经的阻滞效果显著。

Abstract:

Objective: To investigate the safety of epidural injection with chemical neurolytic drugs.Methods: Forty-two rabbits were randomly divided into 7 groups and epidural injections were performed with absolute alcohol,7.5% or 15% phenolglycerin in lower lumbar or middle thoracic level respectively.Animal behavior changes,motion function of hind extremities,the haemorrhage probability in epidural soft tissues induced by recatheterization and pathologic changes of local soft tissues were observed.Results: Significant lesions including grading hind legs paralysis,fecal incontinence and urinary retention were showed in the rabbits with epidural injection at lower lumbar level with alcohol or phenolglycerin.The mortality of rabbits reached 72% in these groups when specialized care was not given in 2 weeks.In the meantime,no evident behavior changes were observed in the rabbits undergoing epidural injection at middle thoracic level and no haemorrhage tendency and severe local pathologic changes occured 3 months later.Conclusion: The results revealed that the motor nerves and autonomic nerveus system may be blocked predicatively by epidural injection with absolute alcohol or phenolglycerin.