家犬正中神经缺损后腕屈肌移植的形态学研究  

Morphology of flexor muscle of wrist transplanted into median nerve defect in do gs

作　　者：苏秋香[1] 王淑华[1] 孙佩杰[1] 杨晓霞[2] 辛畅泰[3] 王彦生[3] 魏侃[3] 

机构地区：[1]沈阳医学院组胚教研室,辽宁省沈阳市110034 [2]沈阳医学院病理教研室,辽宁省沈阳市110034 [3]沈阳医学院附属中心医院手外科,辽宁省沈阳市110041

出　　处：《中国临床康复》2005年第2期118-119,共2页Chinese Journal of Clinical Rehabilitation

摘　　要：目的:探索失神经支配的腕屈肌在自体和异体神经移植后的形态变化,为延缓肌萎缩提高神经再生效果提供形态学依据。方法:实验于2004-01/05在沈阳市中心医院手外科研究所完成。采用8只家犬失去神经支配的腕屈肌为研究对象,分为自体神经移植组和异体神经移植组两组,自体神经移植组:左肢正中神经缺损采用自体正中神经移植;异体神经移植组:右肢正中神经缺损采用异体正中神经移植。术后不同时间取材,常规制成光、电镜标本。结果:自体神经移植组腕屈肌的细胞核增多,为(203.88±16.64)个,异体神经移植组为(112.63±12.07)个,且延续时间较长;肌萎缩变化不明显,特别是术后180d,正常肌纤维的数量自体神经移植组为(20.75±2.50)条,异体神经移植组为(11.25±1.98)条,自体神经移植组远远多于异体神经移植组;随术后时间的延长,自体神经移植组腕屈肌的运动终板和肌梭的结构逐渐恢复,明显好于异体神经移植组,尤以术后180d效果更为明显;自体神经移植组肌纤维间神经纤维束明显增多,而增生的结缔组织明显减少。结论:神经再生效果愈好,其支配的肌肉发生萎缩越慢,肌肉恢复的效果愈佳;失去神经支配的肌肉其细胞核的增多和延续,可能在延缓和恢复肌萎缩过程中有着重要作用。AIM:To investigate the morphological changes of denervated flexor muscle of wr ist after autografting or allografting of median nerves so as to provide morphol ogical bases for postponement of the muscle atrophy and promotion of nerve regen eration. METHODS:The experiment was conducted in the Institute of Hand Surgery,Shenyang Central Hospital from January to May 2004.Eight dogs whose flexor muscle of wri st was denervated were studied and divided into autografting group and allograft ing group.In the autografting group,autografts of median nerves were implanted i nto the median nerve defect of left limbs,and in the allografting group,allograf ts of median nerves were implanted into the median nerve defect of right limbs.T he flexor muscles of wrist samples were selected at different postoperative time and then were observed under light and electron microscopes routinely. RESULTS:The quantity of nuclei was increased in the flexor muscle of wrist in the autografting group(203.88±16.64),and maintained a long duration in the allo grafting group(112.63±12.07).Muscle atrophy is unobvious in the autografting gr oup,especially at 180 days after operation.The quantity of normal muscle fibers in autografting group[(20.75±2.50) pieces] was significantly more than that in allografting group[(11.25±1.98) pieces]. As the time gradually prolonged,the structures of motor end plate and muscle s pindle in the autografting group recovered normal,and were better than those of allografting group,especially at 180 postoperative days.In the autografting grou p,the nerve fibre bundles were obviously increased and the proliferative connect tissues obviously decreased among muscle fibers. CONCLUSION:The better the effect of never regeneration is,the slower the rate of muscle atrophy is,and the better the recovery of the atrophic muscle is.The i ncreased quantity of nuclei and prolonged duration in the denervated muscle may play important roles in postponing and recovering atrophic muscle.

关 键 词：移植 同种 移植 异种 正中神经 

分 类 号：R641[医药卫生—外科学]