颌面部爆炸伤后面神经、下颌神经和迷走神经创伤恢复过程的差异  

The Difference during Restoration Process in Patients with Facial, Mandibular and Vagus Nerves After Maxillofacial Blast Injury

作　　者：王彦亮[1] 王大章[1] 赖西南 张良潮[2] 雷德林 周树夏 刘彦普 

机构地区：[1]四川大学华西口腔医学院,610041 [2]第三军医大学大坪医院野战外科,400042 [3]第四军医大学口腔医院颌面外科,710032

出　　处：《美中国际创伤杂志》2006年第2期5-7,共3页U.S.Chinese International Journal of Traumatology

基　　金：本课题受中国博士后科学基金资助（项目号：20040350135）

摘　　要：目的：不同类型的神经受到损伤后其恢复的过程也有所不同。在头面部爆炸伤中，由于爆炸致伤范围广，同时头面部有多种不同类型脑神经分布，因此常伴有不同类型的神经间接性损伤。以往对不同类型的神经比较颌面部爆炸伤后运动、感觉及植物神经创伤恢复过程的差异。方法：20只犬爆炸致伤后分别在伤后不同时间取材面神经、下颌神经和迷走神经，并用免疫组化检测三种神经中神经特异性烯醇化酶（the neuron-specific enolase，NSE）的表达变化，来分析这三种类型神经爆炸伤后恢复过程的差异。结果：三种神经伤后均出现NSE水平的迅速下降，随着神经的恢复，神经的NSE免疫组化染色逐渐恢复阳性。面神经最早在伤后1周出现阳性，而下颌神经和迷走神经均在伤后24h内即开始恢复NSE阳性。结论：在颌面部爆炸伤中，面神经往往伤情较迷走神经和下颌神经重。Objective： To compare the difference during restoration process in patients with the maxillofacial motor, sensory and autonomic nerves after blast injury. Methods： The specimens of facial, mandibular and vagus nerves were obtained from 20 dogs at serial times after blast injury, and the expression of neuron-specific enolase （NSE） in the three nerves was detected by the immunocytochemical stain as an index of neuronal regeneration and reinnervation. Results： The level of NSE reduced rapidly in three types of nerves after injury and rised along with the recovery of nerves. The mandibular and vagus nerves began to show positive of NSE within 24 hours after injury, but the facial nerve showed a positive result 1 week later. Conclusion： The condition of facial nerve injury is worse than the vagus and mandibular nerves in patients with maxillofacial blast injury.

关 键 词：面神经 下颌神经 迷走神经 神经特异性烯醇化酶 

分 类 号：R782.2[医药卫生—口腔医学]