神经肌蒂移位预防失神经肌萎缩的实验研究  

NEUROMUSCULAR PEDICLE TRANSPLANTATION FOR PREVENTION OF ATROPHY IN DENERVATED MUSCLE

作　　者：李刚[1] 常文凯[1] 田江华[1] 梁炳生[1] 

机构地区：[1]山西医科大学第二医院骨科,太原030001

出　　处：《中国修复重建外科杂志》2007年第6期565-567,共3页Chinese Journal of Reparative and Reconstructive Surgery

摘　　要：目的研究神经肌蒂移位对骨骼肌失神经肌萎缩的预防作用。方法选用SD大鼠48只,随机分为四组,每组12只。建立右下肢失神经胫骨前肌加腓骨长肌神经肌蒂移位为A组;右下肢失神经胫骨前肌加腓浅神经干埋植为B组;右侧腓总神经离断,胫骨前肌失神经对照为C组;正常对照为D组。每组随机均分为两批,分别于术后6周和12周进行步态分析、电生理检测、胫前肌湿重检测和肌纤维截面积检测,并进行评价。结果术后6周,A组在步态分析(神经功能指数为-47.20±12.30)、电生理检测、胫前肌湿重检测(0.3840±0.0246g)和肌纤维截面积(1040.98±120.54μm2)等各项指标都明显优于C组(分别为-114.40±14.84、0.1730±0.0191g和585.08±182.93μm2),差异有统计学意义(P<0.05);胫前肌湿重、肌纤维截面积检测优于B组(分别为0.2940±0.0564g和763.92±82.68μm2),差异有统计学意义(P<0.05)。术后12周A组肌纤维截面积1360.10±261.45μm2与D组1544.57±266.92μm2比较差异无统计学意义(P>0.05),达到正常值范围;A组在步态分析(神经功能指数为-31.60±25.34)、电生理检测、肌纤维截面积方面均优于B、C两组,比较差异有统计学意义(P<0.05)。结论神经肌蒂移位对失神经肌萎缩有预防作用,对失神经肌萎缩预防效果优于神经干埋植。Objective To investigate the effect of the neuromuscular pedicle transplantation in prevention against atrophy in the denervated muscle. Methods Forty-eight SD rats were used to establish the right side tibialis anterior muscle denervation model. The long peroneal muscle neuromuscular pedicle was made as a treatment in 12 rats （Group A） ; the nerve shaft embedding was used in 12 rats （Group B） ; no treatment was used in 12 rats （Group C） ; the remaining 12 rats were used as normal controls （Group D）. The gait analysis, electromyogram,muscle wet weight, and muscle fiber cross-sectional area were used to determine and compare the effect of the operation at 6 and 12 weeks postoperatively. Results At 6 weeks postoperatively, the parameters tested in Group A about the gait analysis （peroneal function index, PFI, - 47. 20±12. 30）, electromyogram, muscle wet weight （0. 384 0±0. 024 6 g） and muscle fiber cross-sectional area （1 040. 98 ± 120. 54μm^2） were significantly better than those in Group C （PFI, -114. 40±14. 84; muscle wet weight, 0. 173 0±0. 019 1 g; muscle fiber cross-sectional area, 585.08±182.93μm^2 , P〈0. 05）, and the final two parameters were significantly better than those in Group B （0. 294 0±0. 056 4 g, 763.92±82.68 μm^2, P〈0. 05）. At 12 weeks postoperatively, the muscle fiber cross-sectional area in Group A （1 360. 10±261.45 μm^2） had no significant difference from that in Group D （1 544.57±266.92 μm^2,P〉0. 05）,and most of the parameters tested in Group A were better than those in Groups B and C. Conclusion Neuromuscular pedicle transplantation has an excellent effect in prevention against atrophy in the denervated muscle, and the effect of neuromuscular pedicle transplantation is better than that of the nerve shaft embedding.

关 键 词：失神经支配 肌萎缩 神经肌蒂 移位 

分 类 号：R651.3[医药卫生—外科学]