健侧颈_7神经根移位修复多条神经模型的建立及功能恢复动态观察  

Contralateral C_7 transfer to multiple recipient nerves: animal model and dynamic evaluation of functional recovery

作　　者：孙贵新[1] 顾玉东[1] 李继峰[1] 李文军[1] 王欢[1] 

机构地区：[1]复旦大学附属华山医院手外科

出　　处：《中华手外科杂志》2006年第1期50-52,共3页Chinese Journal of Hand Surgery

基　　金：国家自然科学基金资助项目(30371435);国家重点基础研究发展计划(973项目:2003CB515305)

摘　　要：目的比较七种不同术式的健侧颈7神经根移位术后受体神经的功能以探讨颈7神经重建多组神经的可行性。方法SD大鼠105只,随机分为7组,每组15只。建立传统的健侧颈7移位经尺神经近端(单根)接正中神经或肌皮神经或桡神经(A、D、G组),健侧颈7经尺神经近端(2股,合干法)接正中、肌皮神经或正中、桡神经(B、E组),健侧颈7经尺神经及腓肠神经(分干法)接正中、肌皮神经或正中、桡神经(C、F组)。术后观察患肢功能,抓握力及梳洗动作出现时间。结果术后2个月,修复正中和肌皮神经的B、C组,均出现主动屈趾、屈肘功能。抓握力比较合干法(B、E组)、分干法(C、F组)及传统法(A、D、G组)的差异均有统计学意义(P<0.05)。术后3、6个月合干、分干法与传统法比较差异无统计学意义(P>0.05)。梳洗试验出现时间合干、分干法及传统法比较差异无统计学意义(P>0.05)。结论颈7神经根能提供足够的神经再生纤维,可同时恢复2条神经功能。Objective To evaluate the results of 7 different surgical procedures of eontralateral C7 transfer and investigate the possibility of C7 transfer to more than one recipient nerves. Methods 105 Sprague Dawley rats were randomly divided into 7 groups with 15 each. In groups A, D, and G conventional contralateral C7 transfer to the median nerve, musculoeutaneous nerve, and radial nerve was done respectively. In group B C7 was transferred to both the median and musculoeutansous nerves via ulnar nerve graft, while in group E the recipient nerves were the median and radial nerves. In group C C7 was used to neurofize the median nerve via ulnar nerve graft and the musculocutaneous nerve via sural nerve graft. The median and radial nerves were neurotized by C7 via ulnar nerve graft and sural nerve graft respectively in group F. Postoperatively movement of the limb, grip strength, and grooming test were observed. Results 2 months postoperatively finger flexion and elbow flexion were seen in groups B and C where both the median and museuloeutaneous nerves were repaired. As for grip strength, significant differences were observed among groups of various designs, i.e. groups B and E versus groups C and F versus groups A, D, and F. These differences, however, became non-significant in 3 and 6 months. Grooming test showed no significant differences among the groups. Conclusion The result indicated that there were enough regenerating nerve fibers in the new procedures. C7 can be used to neurotize two recipient nerves.

关 键 词：臂丛 神经再生 动物 实验 健侧颈 移位 

分 类 号：R651.3[医药卫生—外科学]