肌筋膜管桥接修复面神经缺损的作用  

Effect of epimysium conduit in repairing facial nerve defect

作　　者：钱月楼[1] 曾令勇[2] 钱冉[1] 

机构地区：[1]咸宁医学院神经生物学教研室,湖北省咸宁市437100 [2]咸宁医学院附属第一医院神经科,湖北省咸宁市437100

出　　处：《中国临床康复》2006年第21期55-57,共3页Chinese Journal of Clinical Rehabilitation

基　　金：湖北省教育厅基金资助项目(2003-162)~~

摘　　要：目的:观察肌筋膜管替代神经材料对面神经缺损的修复作用,为进一步提高面神经功能提供理论依据。方法:实验于2005-02/07在咸宁医学院神经组化研究室进行,选择日本大耳白兔24只,切去其双侧面神经上颊支0.5cm作为动物模型。肌筋膜管桥接组:以肌筋膜管桥接右侧面神经颊支的缺损;外膜直接缝合组:左侧面神经颊支被直接缝合,分别于术后5和8周进行大体观察,神经传导速度检测,组织学观察等,以比较两组(侧)面神经颊支的再生情况。结果:实验白兔24只均纳入结果分析。①术后5和8周形态及组织学观察显示肌筋膜管桥接组瘢痕明显少于神经直接缝合的对照组。②术后5周时组织图像分析显示桥接段再生有髓轴突数目和再生(恢复)率,肌筋膜管桥接组明显优于神经直接缝合组犤肌筋膜管桥接组:(1032±234)根/片和(23.72±7.26)%,外膜直接缝合组:(678±193)根/片和(15.70±5.23)%,t=2.52,P<0.01犦。③术后8周时电生理检测两组桥接段再生轴突的电传导速度显示肌筋膜管桥接组明显快于神经直接缝合组犤肌筋膜管桥接组:(17.69±0.14)m/s;外膜直接缝合组:(14.82±0.12)m/s,t=2.390,P<0.01犦。结论:在面神经损伤修复术中,肌筋膜管桥接治疗神经缺损的效果好于神经张力下直接缝合。AIM： To investigate the effects of epimysium conduit to repair facial nerve defect and provide theoretic basis for further improving the functions of facial nerve. METHODS： The experiment was carried out at the Staff Room of Neuro Histochemistry, Xianning Medical College from February to July 2005, Totally 24 Japanese big-ear rabbits were used in this experiment. Animal models were created by resecting 0.5 cm defect of zygomatic branch of bilateral facial nerves. Defects of zygomatic branch of right facial nerve were bridged with epimysium conduit serving as experiment group, and the left same defects were directly sutured serving as control group. Gross observation, detection of nerve conduction velocity, histological observation were performed at postoperative 5 and 8 weeks to compare the regeneration of facial zygomatic branch between the two groups. RESULTS： All the 24 rabbits entered the stage of result analysis. ① In macroscopic and histological evaluations at .postoperative 5 and 8 weeks, the formation of scars was significantly less in experimental group than in control group. ②The histological image analysis showed that the amounts of myelinated nerve fiber and regeneration ratio in experimental group were superior to those in control group [Experimental group： （1032±934） slip/slice and（23.72±7.26）%,Control group： （678±193）slip/slice and（15.70±5.23）%, t=2.52,P 〈 0.01]. ③Electrophysiological examination at postoperative 8 weeks showed that nerve conduction velocity of regenerated axon at the bridged segment was significantly faster in experimental group than in control group [Experimental group： （17.69 ±0.14）m/s;control group： （ 14.82±0.12）m/s ,t=2.396,P 〈 0,01]. CONCLUSION： In the repair of facial nerve injury, the effect of bridging facial nerve defect with epimysium conduit is better than that of pure neurorrhaphy under the nerve tension

关 键 词：面神经损伤 动物 实验 组织学 比较 

分 类 号：R318.08[医药卫生—生物医学工程]