背景：课题组考虑到新鲜冰冻血浆在临床上有综合治疗的价值，如抗休克、免疫、止血和解毒等，并能纠正胶体渗透压。如果在限水、补钠的同时补充新鲜冰冻血浆能提高脊髓损伤患者血钠水平，将为临床治疗脊髓损伤后低钠血症找到一个新的突破点。 目的：建立家兔颈脊髓损伤并发低钠血症动物模型，观察输入新鲜冰冻血浆治疗颈脊髓损伤并发低钠血症的疗效。 方法：健康成年家兔60只，采用改良ALLen氏打击法制作家兔颈脊髓损伤模型，将幸存且合并低钠血症的40只家兔随机分为2组，对照组20只，实验组20只，再按取标本时间不同依次分为1，3，6，10，15 d组，共10组，每组4只。实验组家兔出现低钠血症后每24 h静脉输入20 mL新鲜冰冻血浆(即1 d组输入1次，3 d组输入3次，6 d组输入6次，10 d组输入10次，15 d组输入15次)。对照组家兔每24 h静脉输入20 mL生理盐水。各组动物分别于术前及输入血浆后24 h采取标本分别进行血清钠离子及脊髓组织钠离子测定。 结果与结论：①术后3 d和术后6 d时实验组及对照组家兔的平均血钠浓度较术前明显降低(P<0.05)。术后10，15 d时实验组血钠浓度升高，而对照组血钠水平持续下降，与实验组血钠水平比较差异有显著性意义(P<0.05)。②术后3，6 d时实验组及对照组家兔脊髓组织钠浓度较空白对照组明显升高(P<0.05)。实验组输入血浆10 d后脊髓组织钠浓度逐渐恢复，而对照组脊髓组织钠浓度持续升高，与实验组脊髓组织钠浓度比较差异有显著性意义(P <0.05)。结果可见颈脊髓损伤后易并发低钠血症，输入新鲜冰冻血浆对颈脊髓损伤并发低钠血症的纠正有一定作用。%BACKGROUND:Studies have shown that fresh frozen plasma has comprehensive treatment value in clinic, such as anti-shock, immunology, hemostasis and detoxification, and it can correct the col oid osmotic pressure. Complementing the fresh frozen plasma during water limitation and sodium supplement can increase the sodium levels in patients with spinal cord injury, which provide a new breakthrough for hyponatremia after clinical treatment of spinal cord injury. OBJECTIVE:To establish a rabbit model of cervical spinal cord injury combined with hyponatremia, and to observe the effectiveness of fresh frozen plasma transfusion for hyponatremia after cervical spinal cord injury. METHODS:Sixty healthy adult rabbits subjected a Al en’s punch method to establish rabbit models of cervical spinal cord injury. Forty survived and hyponatremia rabbits were randomly divided into two groups:control group and experimental group, 20 rabbits in each group, and then each group was divided into 1, 3, 6, 10 and 15 days group according to time for taking the specimens, a total of 10 sub-groups and 4 rabbits in each sub-group. The rabbits in the experimental group were injected with 20 mL fresh frozen plasma at 24 hours after hyponatremia appeared (1 day group was injected for one time, 3 days sub-group was injected for three times, 6 days sub-group was injected for six times, 10 days sub-group was injected for 10 times and the 15 days sub-group was injected for 15 times). The rabbits in the control group were injected with 20 mL normal saline every 24 hours. The specimens in each group were taken before operation and 24 hours after fresh frozen plasma transfusion to detect the sodium ions in the plasma and spinal tissue. RESULTS AND CONCLUSION:Sodium concentration in plasma and spinal cord of the control group and experimental group at 3 and 6 days after operation was significantly decreased when compared with that before operation (P<0.05). Sodium concentration in plasma and spinal cord of the experimental group at 10 and 15 days after operation was increased, while the control group was decreased continuously, and there was significant difference of sodium concentration between control group and experimental group (P<0.05). Sodium concentration in the spinal cord of the control group and experimental group at 3 and 6 days after operation was significantly increased when compared with that of the blank control group (P<0.05). Sodium concentration in the spinal cord of the experimental group was returned to normal level after fresh frozen plasma injected for 10 days, while the sodium concentration of the control group was increased continuously, there was significant difference of sodium concentration in the spinal cord between the control group and the experimental group (P<0.05). Hyponatremia is a common complication after cervical spinal cord injury. Fresh frozen plasma transfusion is a good way to treat hyponatremia after acute cervical spinal cord injury.
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