模拟膈神经生物电刺激促进周围神经再生的实验研究  

A histochemical study of promoting peripheral nerve regeneration with simulated bioelectrical impulse of phrenic nerve

作　　者：夏奕俊[1] 徐向阳[2] 崔茂龙[3] 王成[3] 

机构地区：[1]上海瑞金医院集团闵行医院骨科,201100 [2]上海瑞金医院骨科 [3]上海第二医科大学生物医学工程教研室

出　　处：《中华手外科杂志》2004年第4期246-248,共3页Chinese Journal of Hand Surgery

基　　金：上海第二医科大学科学技术发展基金资助项目 (2 0 0 1校1 9)

摘　　要：目的　研究膈神经生物电脉冲 (bioelectricalimpulseofphrenicnerve ,BIPN)在周围神经再生过程中的作用。方法　取家兔 18只 ,共 3 6根坐骨神经 ,平均分为 3组。A组为模拟膈神经生物电脉冲(BIPN)组。B组为连续方波脉冲刺激组。C组为不作任何刺激对照组。术后 4周 ,取材检测。神经标本比较神经纤维计数、截面积及远端有髓纤维通过率。取胫前肌标本检测肌纤维截面积。结果　A、B、C 3组的神经缝合口远端有髓神经纤维计数分别为 12 3 6.9+ 2 0 2、10 82 .5 + 2 14 .6和 840 .6+ 174.4根。A、B 2组比较 ,差异有统计学意义 (t值 3 .3 2 3、P值 <0 .0 1)。A、B、C 3组的神经纤维通过率分别为 5 8.5 + 7.0 1、5 3 .2 + 10 .4和 3 5 .2 + 7.3 %。A、B 2组比较 ,差异有统计学意义 (t值 2 .2 2 1、P值 <0 .0 5 )。A、B、C 3组的神经纤维截面积分别为 12 7.4+ 7.2、119.1+ 5 .2和 118.8+ 5 .5 μm2 。A、B 2组比较 ,差异有统计学意义 (t值 4.3 98、P值 <0 .0 1)。A、B、C 3组的肌纤维截面积分别为 70 4.8+ 10 8.5、62 3 .3 + 189.1和 5 80 .5 + 10 8.3μm2 。A、B 2组比较 ,差异有统计学意义 (t值 2 .3 0 8、P值 <0 .0 5 )。结论　模拟膈神经电脉冲能有效促进周围神经损伤后的神经纤维再生。Objective To study the effect of bioelectric impulse of phrenic nerve (BIPN) on peripheral nerve regeneration. Methods 18 New Zealand rabbits were divided into 3 groups after sciatic nerve transection and coaptation in an end-to-end fashion. Stimulation simulating BIPN was delivered to animals of group A, while continuous square-wave stimulation was given to animals of group B, and no stimulation was applied to animals of group C. Evaluation was carried out 4 weeks following stimulation. Nerve samples were taken to measure the nerve fiber count, nerve fiber cross-sectional area, and passing rate of myelinated regenerated nerve fibers. The anterior tibialis muscles were harvested to measure muscle fiber cross-sectional area. Results Nerve fiber counts of myelinated nerve fibers distal to the coaptation site in groups A, B and C were 1236.9±202, 1082.5±214.6, and 840.6±174.4 respectively. The difference between group A and B was statistically significant (t=3.323, P<0.01). Nerve fiber passing rates were 58.5±7.01%, 53.2±10.4%, and 35.2±7.3% in groups A, B and C respectively. The difference between group A and B was statistically significant (t=2.221, P<0.05). Nerve fiber cross-sectional areas in groups A, B and C were 127.4±7.2μm2, 119.1±5.2μm2, and 118.8±5.5μm2 respectively, while muscle fiber cross-sectional areas were 704.8±108.5μm2,623.3±189.1μm2, and 580.5±108.3μm2 respectively. Significant differences existed between groups A and B (t=4.398, P<0.01; t=2.308, P<0.05). Conclusion BIPN can promote regeneration of the peripheral nerve.

关 键 词：膈神经 周围神经再生 神经纤维 生物电 电刺激 统计学 实验研究 平均分 冲刺 意义 

分 类 号：R651.3[医药卫生—外科学] G633[医药卫生—临床医学]