神经干端侧吻合后侧支发芽能力的实验研究  

EXPERIMENTAL STUDY ON THE COLLATERAL SPROUTING AFTER END TO S IDE ANASTOMOSIS OF NERVE TRUNK

作　　者：曹学诚[1,2] 矢岛弘嗣 玉井进 蔡锦方[1,2] 

机构地区：[1]济南军区总医院骨创伤科 [2]日本国奈良县立医科大学整形外科

出　　处：《中国修复重建外科杂志》1997年第6期321-324,共4页Chinese Journal of Reparative and Reconstructive Surgery

摘　　要：为观测神经干在端侧吻合后的侧支发芽能力，分别在供体神经上作外膜开窗，检查其侧支发芽情况，并与端端吻合作比较。实验用１６只成年ＳＤ大白鼠，将其随机分为４个组。１组，腓神经切断后在胫神经外膜上开窗，然后将两者作端侧吻合。２组，手术步骤同１组，但不作胫神经外膜开窗。３组，胫神经不开窗，离断的腓神经与胫神经平行缝合。４组，腓神经切断后立即行端端吻合。术后３个月，所有动物分别测定腓神经功能指数（ＰＦＩ），乙酰胆碱转移酶（ＣｈＡＴ）活性，并作组织学检查。结果显示，第１组与第２组的ＰＦＩ，ＣｈＡＴ活性无明显差异（Ｐ＞０．０５）。组织学检查证实，侧支发芽纤维的存在，即使在第３组，也可见到大量的神经纤维，侧支发芽的纤维为小的有髓纤维。但１组的ＣｈＡＴ活性仅是第４组的２／３。结果提示，外膜鞘在远期对神经的侧支发芽能力几乎没有影响。神经侧支发芽能力比我们通常想象的要强，但在临床应用以前尚需作进一步研究。In order to observe the collateral sprouting capacity of the nerve trunk after end to side anastomosis, a window was made on the epineurium of the donor nerve through which the result of the end to end anastomosis of nerves could be compared. Sixteen SD rats were chosen and divided into 4 groups randomly. Group 1, the peroneal nerve was severed, the epineurium of the tibial nerve was fenestrated and sutured the peroneal stump with the tibial nerve by end to side neurorrhaphy. Group 2, operative procedures were almost the same as that of Group 1, but no fenestration on the epineurium was done. Group 3, the distal peroneal nerve stump was sutured in paralell with the tibial nerve without fenestration on the tibial nerve and Group 4, severed the peroneal nerve and sutured the stumps by end to end anastomosis immediately. The peroneal function index(PFI) and acetylcholine transferase (ChAT) activity were assessed and the histological examination was performed in all rats. The results showed: between group1 and 2, there was no difference in PFI and ChAT activity (P>0.05). The existence of collateral sprouting in all groups was proved by histological examination. Even in Group 3, there were plenty of nerve fibers turned into tiny myelined nerve fibers through collateral sprouting. But the ChAT activity in Group1 was only two thirds of that in Group 4. It was suggested that the epineurial sheath did not influence the collateral sprouting of the nerve.

关 键 词：周围神经 神经干 端侧吻合 侧支发芽 

分 类 号：R651.3[医药卫生—外科学]