黄体酮促进端侧吻合外周神经再生的实验研究  

The promotion of nerve regeneration in peripheral nerve by progesterone after terminolateral neurorrhaphy: an experiment study

作　　者：樊飞 郑仰林[2] 张顺 张德成 

机构地区：[1]山西省大同市第三医院骨科,037008 [2]山西医科大学第一医院骨科

出　　处：《中华显微外科杂志》2006年第1期35-38,共4页Chinese Journal of Microsurgery

摘　　要：目的 探讨黄体酮对外周神经端侧吻合后神经侧芽生长及远段神经再生的影响。方法 选用雌性SD大鼠36只，周龄9～10周。随机分为2组，黄体酮（PROG）组和对照组，每组18只。两组均先切除双侧卵巢，2周后行腓总神经和胫神经端侧吻合术。PROG组：切断左侧腓总神经，在同侧的胫神经干外膜上开一面积为1mm×1mm小窗，将腓总神经远端吻合到胫神经干侧方开窗处，近端反转包埋于附近肌肉内。经臀部肌内每日注射PROG注射液（10me,／m1）0．2ml；对照组：吻合方法同PROG组，术后注射等量的茶油0．2ml。各组分别于术后4周、8周、12周进行神经电生理、组织学和形态定量学检测。结果 外周神经端侧吻合后，两组腓总神经均有一定程度再生。PROG组在各时间点．运动神经传导速度、腓总神经远端再生有髓神经纤维截面积、再生有髓神经纤维数目均明显优于对照组（P〈0．05）。透射电镜结果显示PROG组较对照组髓鞘更为成熟，轴索再生明显。结论 黄体酮可以促进外周神经端侧吻合后神经侧芽生长及远段神经再生和功能恢复。Objective To evaluate the effect of progesterone （PROG） on promoting peripheral nerve collateral growth and nerve regeneration after terminolateral neurorrhaphy （TLN）. Methods Thirty-six female SD rats were from nine to ten weeks old and weighed from 250 to 270 grams. They were randomly divided into two groups by different drugs they were administrated, the PROG group and the control group. Both groups were subdivide into three groups respectively, PROG four weeks group, PROG eight weeks group, PROG twelve weeks group, control four weeks group, control eight weeks group and control twelve weeks group. There were six subjects in every subgroups. First, both groups were performed ovariectomy. Then, two weeks later, TLN was operated. In the PROG group, the left peroneal nerve was transected, then an 1 mm epineukral window was created on the neighbouring. The distal end of peroneal nerve was sutured to the windowed tibial nerve by means of end-to-side attachment. In the control group, nerve TLN was performed as in the PROG group, 0. 2ml （10mg/ml） PROG and tea-oil （the solvent of PROG） was injected by subcutaneous injection for days in PROG group and control group respectively. Electrophysiological, histolgicial and morphological examinations were measured at 4,8, and 12 weeks after the operation. Results Regeneration of peroneal nerve occurred in both groups. All the data were analysed by factorial designed analysis of variance. The out- put demonstrated that there was a signficant difference in the quality of regeneration of peroneal between PROG group and control group （ P 〈 0.05 ）. The quality of regeneration of peroneal in PROG group was better than that in control group. Because there was no interaction between drug factor and time factor, we compared the effect of PROG between the two groups at every stage to investigate when the effect of PROG emerged. In the experiment, motor nerve conduction velocity in PROG group was better than those in control group at week four, which showes that th

关 键 词：外周神经 端侧吻合 黄体酮 神经再生 

分 类 号：R651.3[医药卫生—外科学] R651.305[医药卫生—临床医学]