Induced Spinal Cord Injury (II): Disease Complication and Patient Care

誘發性脊髓傷害（II）：併發病及照顧

洪昭竹(Chou-Chu Hong) ； 徐亦薇(Yi-Ve Hsu) ； 王明升(Ming-Hseng Wang)

《中華民國獸醫學會雜誌》 23卷6期 (1997/12) Pp. 492-499

https://doi.org/10.7009/JTCSVS.199712.0492

摘要

大鼠誘發性第一腰脊髓傷害動物模式已經明確建立。在誘發性脊髓傷害後，有些併發症亦隨之發生。主要併發症包括血尿、膿尿、尿道感染、尿迫阻塞、溶血和自殘。誘發性脊髓傷害在初期時，因腎血管、腎小管和腎小球的損傷而導致血尿；而後再由神經原性膀胱誘發出血性膀胱炎。如果沒有出現膿尿及蛋白尿，則動物癒後良好。尿道感染及膿尿主要源自於神經原性膀胱及貯尿，再加上排泄物污染所引起；尿道阻塞都發生在松鼠上，因為尿道較長且彎曲不易排除，因而引起腎衰竭及膀胱破裂而死。大鼠自殘常出現在脊髓傷害復原期間，起因於大鼠感覺不良性疼痛症候群，包括：感覺過敏及痛覺過敏，其自殘部位以腳指為主。上述併發症可以經下列手術及良好的照顧，減少其發生與死亡，包括：（1）在誘發性脊髓傷害後7天內，每天以預防性抗生素gentamycin（20 mg/kg BW）肌肉注射，（2）每天人工擠尿二次，（3）脊髓傷害後3至5天，給予輔助療法腹腔注射氯基酸，葡萄糖和電解質，（4）將脊髓傷害之動物置放於室溫28-30℃之內。

關鍵字

誘發性脊髓傷害 ； 併發症 ； 照顧 ； 大鼠

並列摘要

Standard animal models of induced SCI at the L1 region in rats has been established. During the experimental period, injured rats developed several complications secondary to SCI that would affect the overall survival of the rats. Most significant injury complications are hematuria, pyuria, UTI's, urethral obstruction, hemolysis and self-mutilation. Hematuria in the early stages of recovery caused severe blood vessel and renal glomerular tubule damage. As the rats became stable, hemorrhagic cystitis developed due to neurogenic bladder. Prognosis for SCI rats was satisfactory if further complications such as pyuria and proteinuria did not develop. Neurogenic bladders and urinary retention caused UTI's and pyuria due to fecal bacterial contamination. Urethral obstruction occurred only in male rats due to stricture and bladder atonia. This condition subsequently caused renal failure and bladder rupture. Self-mutilation in SCI rats was due to dysthetic pain caused by hyperesthesia and hyperalgesia. SCI rats served as a good animal model for psychosis of self-abuse, self-destruction and self-mutilation in human patients. Injury complications could be reduced by good patient care. There included: (1) prophylactic gentamycin 20 mg/kg for 7 days after injury, (2) manual voiding twice a day, (3) IP warm solution (Amino plex and 5% dextrose with electrolytes for 3-5 days) and (4) room temperature of 28-30℃.

並列關鍵字

Induced spinal cord injury ； Disease complication ； Patient care