面神经端侧与端端吻合的修复效果比较:肌电图评估  

Comparison of the outcomes of end-to-side and end-to-end anastomosis on the facial nerves:Electromyogram evaluation

作　　者：钱月楼[1] 

机构地区：[1]咸宁学院医学院神经生物学教研室,湖北省咸宁市437100

出　　处：《中国临床康复》2005年第29期50-52,共3页Chinese Journal of Clinical Rehabilitation

摘　　要：目的:比较面神经端侧吻合和端端吻合的效果,探索修复面神经缺损的新方法。方法:实验于2004-04/08在咸宁学院医学院神经组化研究室进行。取日本成年大耳白兔14只,随机分为术后1,3个月组两组各7只。所有兔右侧面区切断面神经上颊支,其远心端吻合到外膜开窗的下颊支侧壁,行端侧神经吻合;左侧面区也切断面神经上颊支,断端间行端端神经吻合。分别于术后1和3个月时做肌电图诱发电位检测神经功能恢复情况,并取材作组织学检测评估其神经再生情况。结果:12只兔进入结果分析。①诱发电位潜伏期:术后3个月组左侧和右侧均短于术后1个月[(1.93±0.11),(2.68±0.35)ms;(2.35±0.07),(4.65±0.78)ms,P<0.05]。②波幅:术后3个月组左侧和右侧均高于术后1个月[(9.95±1.27),(7.12±1.16)mV;(5.41±1.40),(1.99±0.41)mV,P<0.05]。③神经传导速度:术后3个月组左侧和右侧均快于术后1个月[(40.93±6.19),(29.56±4.16)m/s;(34.27±7.23)(20.86±5.21)m/s,P<0.05]。④再生神经纤维的直径:术后1,3个月组兔左侧均大于右侧[(3.78±0.52),(2.33±0.28)μm;(6.25±0.69),(4.06±0.73)μm,P<0.05]。⑤再生神经纤维:术后1,3个月组兔左侧均多于右侧[(637.05±94.06),(216.33±35.20)根;(1442.33±86.34),(605.83±143.58)根,P<0.05]。结论:正常神经能发出侧芽通过端侧吻合长入缺损面神经的远残端、使失神经支配面肌再神经化,面神经端侧吻合的效果比端端吻合的效果差,但行端侧吻合修复面神经缺损仍具有一定的临床应用价值。AINI：To evaluate the effects of end-to-side anastomosis and end-to-end anastomosis on the facial nerves, and explore the new methods of repairing facial nerve defection. METHODS：The experiment was performed in the Research Room of Neurology, Medical College of Xianning College between April and August 2004. Fourteen adult Japanese rabbits with big ears were selected, and assigned randomly into 1 and 3 months group post-operation with 7 rabbits in each group. The upper-cheek branches of facial nerve on right sides of all the rabbits were transected,and then its distal end was sutured to the low-cheek branch nerve with epineurial window in an end-to-side anastomosis. The upper-cheek branches of facial nerve on left sides were transected, and then the break end was sutured with end-to-end neural anastomosis. The neural function restoration was detected by the electromyography-induced potential at the 1 and 3 months after operation, respectively, and the materials were drew to conduct histology detection to evaluate the regeneration of nerve condition. RESULTS：Twelve rabbits were involved in the result analysis. ① Latency of induced potential： It was shorter on the left and right sides in the 3 months group after operation than that in the 1 month group [（1.93±0.11）, （2.68±0.35）ms; （2.35±0.07）, （4.65±0.78）ms,P 〈 0.05]. （±） Amplitude of wave： It was higher on the left and right sides in the 3 months group after operation than that in the 1 month group [（9.95 ±1.27）, （7.12±1.16）mV; （5.41±1.40）,（1.99±0.41）mV, P 〈 0.05]. ③ Nerve conduction velocity： It was faster on the left and right sides in the 3 months group after operation than that in the 1 month group [（40.93±6.19）, （29.56±4.16）m/s; （34.27±7.23） （20.86±5.21）m/s, P 〈 0.05]. ④ Diameter of the regeneration nerve fiber： It was bigger on the left side than that on the right side in the 1, 3 months group after operation [（3.78 ±0.52）, （2.33 ±0.28）μm; （6.25 ±0.69）,

关 键 词：面神经损伤/外科学 神经再生 肌电描记术 

分 类 号：R745.1[医药卫生—神经病学与精神病学]