含碘对比剂在猫脊髓造影中的最佳用量及不同对比剂显影效果的研究
发布时间：2019-07-01 13:11
【摘要】：脊髓造影在临床医学中已是一项非常成熟的检查技术,在兽医临床检查中的应用在国外开展较早,各项操作及技术规范较为完善。而在我国,能够查阅到的中文文献多为犬的脊髓造影,国内有相关技术设备的少数大型动物医院,操作较多的也是犬的脊髓造影。在猫,国内文献中能够查询到的相关研究与临床应用的案例少之又少。基于我国基层兽医教育层次的问题,很多一线兽医难以从国外文献中学习相关知识;同时,我国家猫的数量在不断增加,因坠落、车祸等意外事故造成的脊椎损伤病例也呈增长趋势。故而将猫脊髓造影的操作流程及对比剂的使用剂量标准化、精细化将会为广大一线兽医的检查操作带来很多便利;并且能够方便的根据具体病情选择和确定对比剂的种类及规格,从而避免因对比剂用量不足造成的漏诊、误诊或者因用量过大而造成的资源浪费、神经损伤或其它可能出现的不良反应。对于神经系统的检查,现今医学已有较为成熟的设备与技术,如CT、MRI等。但是限于我国动物医院多属于私人资产,此类检查设备多因成本高昂造成相应检查费用超过多数人的消费水平,从而导致此类设备在我国小动物临床诊疗中难以普及。所以脊髓造影技术在未来很长一段时间内,仍将是兽医临床检查中的一大支柱。甚至在人类医学中,脊髓造影对于某些疾病的检出优于CT或MRI,这也是人类医学保留脊髓造影技术至今的主要原因。本研究以健康家猫作为实验对象,以碘海醇和碘帕醇为实验药物来确定脊髓造影时含碘对比剂在猫身上的使用剂量。实验的前半部分以碘海醇为对比剂,以20mgI/kg为分度值、30mgI/kg为起始剂量、270mgI/kg为最大剂量,设置13个实验剂量,通过分时摄片确定出最佳显影效果的剂量以及最适显影时间。本试验以腰椎间隙作为对比剂的注射部位,根据实验动物的个体差异,注射点选定为L5/6或L6/7,动物采用俯卧位行腰椎穿刺术,对比剂注射完毕后分别于第0min、5min、10min、20min、30min和60min摄取正(DV)、侧(RL)位片。通过综合对比分析发现,全脊髓显影的碘海醇用量为150mgI/kg,此剂量下药物注射后10min即可全脊髓显影,至60min椎管内对比剂影像依然可辨。当使用剂量为50mgI/kg时,5min影像显示腰椎段影像完整清晰,至20min腰椎段显影模糊、可见胸椎段显影,至60min腰椎段显影不完全、胸椎段显影尚可、颈椎段仍有显影。准确确定对比剂在猫脊髓造影中的使用计量在我国还是首次,本实验所确定的对比剂使用计量是以其中的碘含量以计算(即计量单位为mgI/kg),所以这一数据适用于同种药物不同规格的产品以及其他多种规格的水溶性含碘对比剂。
[Abstract]:Myelography has been a very mature examination technology in clinical medicine. The application of myelography in veterinary clinical examination was carried out earlier in foreign countries, and the operation and technical specifications were more perfect. In our country, most of the Chinese literature can be found for dog myelography, and a small number of large animal hospitals with related technical equipment in China also operate more dog myelography. In cats, there are very few cases of related research and clinical application that can be queried in domestic literature. Based on the problem of grass-roots veterinary education in our country, it is difficult for first-line veterinary surgeons to learn relevant knowledge from foreign literature. At the same time, the number of cats in our country is increasing, and the cases of spinal injuries caused by falls, car accidents and other accidents are also on the rise. Therefore, standardizing the operation flow of myelography and the use of contrast agent in cats will bring a lot of convenience to the examination and operation of first-line veterinary surgeons, and can conveniently select and determine the types and specifications of contrast agent according to the specific condition, so as to avoid missed diagnosis, misdiagnosis or waste of resources caused by excessive dosage of contrast agent, nerve injury or other possible adverse reactions. For nervous system examination, medicine has more mature equipment and technology, such as CT,MRI and so on. However, limited to the fact that most animal hospitals in our country belong to private assets, most of this kind of examination equipment is more than the consumption level of most people because of the high cost, which makes it difficult to popularize this kind of equipment in the clinical diagnosis and treatment of small animals in our country. So myelography will remain a pillar of veterinary clinical examination for a long time to come. Even in human medicine, myelography is superior to CT or MRI, in the detection of some diseases, which is the main reason for the preservation of myelography in human medicine. In this study, healthy domestic cats were used as experimental objects, and iodohexol and iodophanol were used as experimental drugs to determine the dose of iodine contrast agent in cats during myelography. In the first half of the experiment, iodohexol was used as contrast agent, 20mgI/kg as the starting dose, 30mgI/kg as the initial dose and 270mgI/kg as the maximum dose. 13 experimental doses were set up. The best development effect dose and the optimum development time were determined by time-sharing film. In this experiment, the lumbar intervertebral space was used as the injection site of contrast agent. According to the individual difference of the experimental animals, the injection points were selected as L5 脳 6 or L6. The animals were treated with lumbar puncture in prone position. (RL) films on the (DV), side were taken at 0 min, 5 min, 10 min, 30 min and 60min respectively after injection of contrast agent. Through comprehensive comparative analysis, it was found that the dosage of iodinated alcohol in the whole spinal cord development was 150 mg I 鈮，
本文编号：2508502
[Abstract]:Myelography has been a very mature examination technology in clinical medicine. The application of myelography in veterinary clinical examination was carried out earlier in foreign countries, and the operation and technical specifications were more perfect. In our country, most of the Chinese literature can be found for dog myelography, and a small number of large animal hospitals with related technical equipment in China also operate more dog myelography. In cats, there are very few cases of related research and clinical application that can be queried in domestic literature. Based on the problem of grass-roots veterinary education in our country, it is difficult for first-line veterinary surgeons to learn relevant knowledge from foreign literature. At the same time, the number of cats in our country is increasing, and the cases of spinal injuries caused by falls, car accidents and other accidents are also on the rise. Therefore, standardizing the operation flow of myelography and the use of contrast agent in cats will bring a lot of convenience to the examination and operation of first-line veterinary surgeons, and can conveniently select and determine the types and specifications of contrast agent according to the specific condition, so as to avoid missed diagnosis, misdiagnosis or waste of resources caused by excessive dosage of contrast agent, nerve injury or other possible adverse reactions. For nervous system examination, medicine has more mature equipment and technology, such as CT,MRI and so on. However, limited to the fact that most animal hospitals in our country belong to private assets, most of this kind of examination equipment is more than the consumption level of most people because of the high cost, which makes it difficult to popularize this kind of equipment in the clinical diagnosis and treatment of small animals in our country. So myelography will remain a pillar of veterinary clinical examination for a long time to come. Even in human medicine, myelography is superior to CT or MRI, in the detection of some diseases, which is the main reason for the preservation of myelography in human medicine. In this study, healthy domestic cats were used as experimental objects, and iodohexol and iodophanol were used as experimental drugs to determine the dose of iodine contrast agent in cats during myelography. In the first half of the experiment, iodohexol was used as contrast agent, 20mgI/kg as the starting dose, 30mgI/kg as the initial dose and 270mgI/kg as the maximum dose. 13 experimental doses were set up. The best development effect dose and the optimum development time were determined by time-sharing film. In this experiment, the lumbar intervertebral space was used as the injection site of contrast agent. According to the individual difference of the experimental animals, the injection points were selected as L5 脳 6 or L6. The animals were treated with lumbar puncture in prone position. (RL) films on the (DV), side were taken at 0 min, 5 min, 10 min, 30 min and 60min respectively after injection of contrast agent. Through comprehensive comparative analysis, it was found that the dosage of iodinated alcohol in the whole spinal cord development was 150 mg I 鈮，
本文编号：2508502
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