自体变性骨骼肌-神经束复合体修复大鼠坐骨神经缺损的实验  

Repairing sciatic nerve defect by parallel denatured skeletal muscle-nerve autograft in rats

作　　者：钱月楼[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

出　　处：《中国临床康复》2006年第42期76-78,共3页Chinese Journal of Clinical Rehabilitation

摘　　要：目的:观察自体变性骨骼肌-神经束“并联”复合体桥接大鼠坐骨神经缺损的修复效果及可行性。方法:实验于2005-06/12在咸宁医学院神经组化研究室完成,将Wistar大鼠36只随机分为3组:复合桥组,神经桥组和肌桥组,每组12只。①模型制作:采用2%戊巴比妥钠溶液(0.1mL/50g)经腹膜腔注射麻醉后,显露并切去鼠的右侧坐骨神经一段使形成10mm缺损。另在复合桥组和肌桥组,切取股二头肌外缘纵行肌束,置于60℃水浴变性5min。②分组处理:复合桥组:将缺损远端神经行“束间分离”,等分为两束,切取10mm长的一束与自体变性骨骼肌束“并联”桥接于坐骨神经缺损处并用筋膜包裹;神经桥组:以自体神经原位桥接于神经缺损处;肌桥组:以自体变性骨骼肌束桥接于神经缺损处。③指标测试:术后24周,用肉眼观察桥接体及吻合口外形,取称大鼠双侧胫前肌湿质量,以术侧(右侧)与正常侧(左侧)湿质量百分比作为胫前肌湿质量恢复率;取移植体,以Bielschowsky镀银染色后,石蜡包埋,作纵、横切片,苏木精-伊红复染,光镜下观察和用彩色图像分析仪测量再生神经纤维的数目(密度)、平均直径及髓鞘厚度。结果:实验大鼠36只均进入结果分析,术后24周时,①大体观察:复合桥组和神经桥组的桥接段均有完整的神经外膜和清晰的神经折光横纹,与周围组织粘连轻,吻合处质软,表面光滑,而肌桥组则无完整的神经外膜和神经折光横纹,与周围组织粘连较重,吻合口处质硬,表面粗糙;胫前肌(湿质量)恢复率:复合桥组和神经桥组均较肌桥组高,其差异有显著性[复合桥组(72.19±7.23)%,神经桥组:(75.01±6.21)%,肌桥组:(63.98±6.41)%,P<0.05]。②再生神经纤维的数目(密度):复合桥组和神经桥组均较肌桥组多(密)[复合桥组:(77.78±6.76)×104根/μm2,神经桥组:(78.43±4.56)×104根/μm2,肌桥组:(68.88±2.39)×104根/μm2,P<0.05]。③再生神经纤维直�AIM： To explore the effect and possibility of repairing sciatic nerve defect by parallel denatured skeletal muscle-nerve autograft in rats. METHODS： The experiment was carried out at the Staff Room of Neuro- Histochemistry, Xianning Medical College from June to December 2005. Totally 36 Wistar rats were divided into 3 groups randomly： parallel denatured skeletal muscle-nerve autograft group （complex bridge group）, nerve autograft group （nerve bridge group） and denatured skeletal muscle autograft group （muscle bridge group）, with 12 rats in each.①Modeling： The rats were anesthetized by intraperitoneal injection of 0.1 mL/50 g pentobarbital solution （2%） in each groups, and their right sciatic nerves were exposed in the mid-thigh region to produce a 10 mm defect. A vertical bunch from the exterior margin of femoral biceps was .severed and putted into the 60 ℃ water for 5 minutes in complex and muscle bridge groups.② Treatment in each group： In complex bridge group, the distant section of sciatic nerve was divided into two bunches and severed a 10 mm bunch to bridge in the sciatic nerve defect with the parallel denatured skeletal mus- cle nerve bunch, and the complex autograft was surrounded with the fascia finally. The same defect of sciatic nerve was bridged in situ with pure nerve autograft in nerve bridge group or bridged with pure denatured skeletal muscle autograft in muscle bridge group. ③Test of indexes： The bridge autograft and stoma shape were observed macroscopically, and the wet weight of the tibial anterior muscles were weighted to calculate its restoration ratio of diseased side （right） and normal side （left）; After Bielschowsky silver staining, paraffin imbedding and hematoxylin-eosin staining of longitudinal and transverse sections, the regenerative axonal number （density）, average diameter and myelin thickness were observed under light microscope and measured by color image analyzer. RESULTS： Totally 36 rats were analyzed in the result at 24 week

关 键 词：坐骨神经 肌 骨骼 大鼠 

分 类 号：R745.4[医药卫生—神经病学与精神病学]