兔腰椎间盘内多点注射医用臭氧的实验研究
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Percutaneous intradiscal oxygen-ozone (O3)multipoint injection: an experimental study in conies
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    目的:观察医用臭氧不同注射方式对兔腰椎间盘正常髓核的作用以及安全性-方法:家兔20只,于透视下用20 G 儿童穿刺针刺入家兔腰椎间盘中心部,抽取5 ml浓度为40 μg/ml臭氧,经穿刺针注入3 ml,在椎间孔处将剩余气体注入椎旁组织-其中L4~5为椎间盘内单点注射,L5~6为椎间盘内多点注射,以L3~4椎间盘作为正常对照-20只兔注射臭氧1次,分别在术后1-2-3-4周后处死取标本,将实验和正常对照标本中椎间盘髓核作大体-光镜下观察,并对光镜下髓核内细胞计数行统计学分析-结果:术后实验动物均无严重的行为异常-各手术腰椎间盘术后1周腰椎间盘髓核水分明显减少,外形萎缩,4周髓核干涸,完全呈灰白色干酪样-多点注射组髓核内细胞计数比较单点注射组明显减少,两者差异具有显著性-结论:本研究显示椎间盘内40 μg/ml臭氧注射安全性较好,臭氧对髓核缓慢萎缩作用多点注射强于单点注射方式,为该技术在临床的应用提供了实验依据-

    Abstract:

    Objective:To evaluate the influence of oxygen-ozone on normal nucleus pulposus in cones and the safety of intradiscal oxygen-ozone multipoint injection for the treatment of herniated lumbar disc. Methods:Oxygen-ozone at 40 μg/ml was injected into selected lumbar discs(3 ml) and the paraspinal space(2 ml) with 20G Chiba needle under fluoroscopy in twenty cones. Every cone was given multipoint injection in L5-6 and one point injection in L4-5 respectively. The whole cones were given one time oxygen-ozone injection and were sacrificed for pathology one week, two weeks, three weeks and four weeks respectively after the procedure, specimens in nucleus pulposus were observed macroscopically and microscopically. Results:No serious behavior abnormalities were observed in all animals. The atrophy of nucleus pulposus could be observed one week after oxygen-ozone injection due to significant reduction of water. The nucleus pulposus turned to dry up and looked like gray cheese after four weeks. There was an apparent difference on the cell count of nucleus pulposus between the selected L4-5 and L5-6 intervertebral disc. The cell counting of nucleus pulposus in the L5-6 intervertebral disk decreased obviously. Conclusion:It is suggested that percutaneous intradiscal oxygen-ozone injection at 40 μg/ml is a safe method, and can cause gradual atrophy of nucleus pulposus. The effect on atrophy of nucleus pulposus by multipoint injection model is better than by one point injection. This study provides the evidence of the feasibility and value of this procedure’s dinical application.

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姜建威,吴清华,吴震海,李新胜,成 岗,顾 琛.兔腰椎间盘内多点注射医用臭氧的实验研究[J].南京医科大学学报(自然科学版),2009,29(4):585-588

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  • 收稿日期:2008-10-22
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