直径相异的神经连接方法对神经再生的影响  

Comparative study for the nerve repairs of mismatched nerves

作　　者：章玮[1] 朱静珍[2] 张高孟[3] 沈丽英[3] 张凯丽[3] 

机构地区：[1]上海市第六人民医院骨科,200233 [2]上海医科大学病理解剖教研室 [3]上海医科大学华山医院手外科

出　　处：《实用手外科杂志》1999年第1期32-35,共4页Journal of Practical Hand Surgery

摘　　要：目的探讨直径相异神经的连接方法与神经再生的关系。方法以大鼠臂丛根性撕脱伤为模型,将膈神经移位于外侧束(直径比为1:4),采用干干、干束、包埋和端侧缝合及无间隙和小间隙静脉套接六种连接方法,术后用电生理学、组织学和功能测定评估神经再生和功能恢复情况。结果术后4个月时,各端端吻合组的各项观察指标优于端侧组;各端端吻合组间,除潜伏期和最大收缩持续时间恢复率无明显差异外,静脉套接组的有髓神经纤维通过率优于干束组,其余各项指标显示静脉套接组、干干组、包埋组优于干束组。结论端端吻合优于端侧吻合;干干对合优于干束对合;套接缝合优于直接缝合;无间隙与小间隙静脉套接无明显差异。ve To investgate the relationship between nerve repair of mismatchded nerves and nerve regeneration. Methods The six different neurorrhaphies, they were trunk - to - trunk suture, trunk - to - fascile suture, embedding suture, end - to - side suture, non - and little - gap sleeve insertion through vein conduit, were used to transfer the phrenic nerve to the lateral cord in the rat model of brachial plexus root avulsion. Electrophysiological, histological examinations and functional evaluation were applied to access nerve regeneration and the functional recovery of the biceps brachii muscle postoperatively. Results At fourth month after operation, the end - to - end coaptation groups were superior to the end - to - side group in all observation parameters. Among the end - to - end coaptation groups, except that the delay rates of latency and the maximal persisting time were no statistically significant differences, the myelinated axon counts of the two vein-conduit sleeve insertion groups were superior to that of trunk- to- fascile group. The other observation parameters indicated that the two vein-conduit sleeve insertion groups, embedding group and trunk- to- trunk group have no significant difference, but they were superior to the trunk - to - fascile group. Conclusion (1) The end - to - end coaptation is superior to the end- to-side coaptation. (2)The trunk- to- trunk coaptation is superior to the trunk- to- fascile coaptation. (3) The sleeve insertion is superior to the direct suture. (4)The non- and little- gap vein- conduit sleeve insertion groups have no significant difference.

关 键 词：静脉 神经再生 吻合 缝合 术后 观察指标 臂丛根性撕脱伤 相异 差异 通过率 

分 类 号：R651[医药卫生—外科学] H215[医药卫生—临床医学]