不同神经移植体修复神经缺损的形态和电生理研究  

Morphologic and electrophysiological study of peripheral nerve regeneration contributed to different nerve graftings

作　　者：魏国兴[1] 陈绍宗[1] 李跃军[1] 李学拥[1] 李金清[1] 

机构地区：[1]第四军医大学唐都医院整形科,西安市710038

出　　处：《实用医学杂志》2006年第6期617-619,共3页The Journal of Practical Medicine

摘　　要：目的:研究移植体结构对周围神经再生的影响。方法:新西兰兔12只,随机分为3组。双侧耳大神经各切下1.2cm长一段神经,A组将其原位缝合桥接缺损,B组用隐神经移植体桥接,C组用股外侧皮神经移植体桥接,修复方法采用外膜缝合。术后12周采用电生理检测方法测量神经最大动作电位和传导速度,采用美兰染色方法观察神经结构,ImageProPlus图像分析软件对图片进行分析。结果:术后12周,B组在远侧段动作电位幅值和动作电位幅值恢复率均大于A组和C组,A组大于C组;B组在远侧段神经传导速度大于C组;B组远侧段有髓神经纤维密度和面积大于A组和C组,A组大于C组;B组髓鞘平均厚度大于A组和C组,P<0.05。结论:神经移植体结构对自体神经移植再生效果有影响作用,神经束面积大、轴突密度大且神经截面积小的神经移植体再生效果较好。Objective To study the effect of the neuromechanism of the nerve graft on the regeneration of peripheral nerve defect. Methods 12 New Zealand rabbits were randomly divided into three groups. A 1.2 cm segment of the auficularis magnuses on both sides was resected to establish an artificial defect. In group A, the defect was repaired by the coaptation of both ends of the auricularis magnuses. In group B, the defect was coaptated by saphenous nerve grafting. In group C, the defect was coaptated by lateral femoral cutaneous nerve grafting. The nerve electrophysiological test was preformed to detect the nerve action potential and the conduction velocity, and the neuromechanism was observed by methylthionine chloride staining 12 weeks after the procedure. All of the images were analysed by the Image Pro Plus computer program. Results 12 weeks after the procedure, the amplitude of nerve action potential and its recovery rate in group A were bigger than those in group C while those in group B were the biggest. The nerve conduction velocity in group B was bigger than that in group C. The mean density and area of the myelinated fibers in the distal nerve in group A were bigger than those in group C while those in group B were the biggest. The mean thickness of the myelin in the distal nerve in group B was bigger than that in group A and C （ P 〈 0.05 ）. Conclusion The neuromechanism of the graft nerve could affect the autograft nerve regeneration, and the nerve graft with larger area of its nerve bundle, higher density of its axon but smaller area of its cross section could regenerate better.

关 键 词：神经再生 神经修复 神经结构 

分 类 号：R651.3[医药卫生—外科学] R338.25[医药卫生—临床医学]