大鼠腓总神经端侧吻合于胫神经再生神经的逆行追踪  

Tracing of Regenerating Axons in Peroneal Nerve Neurorrhaphy to Tibial Nerve in Rats

作　　者：魏佑震[1] 顾小兵 张凤鸣[1] 逄小红[1] 巩念明[1] 孙丰刚[1] 

机构地区：[1]泰山医学院解剖学教研室∥脑研究室,山东泰安271000 [2]东莞大朗医院手外科,广东东莞523770

出　　处：《中山大学学报（医学科学版）》2008年第6期720-723,共4页Journal of Sun Yat-Sen University:Medical Sciences

基　　金：山东省自然科学基金(Q99C17);山东省教育厅科技计划项目(J99K64)

摘　　要：【目的】研究大鼠腓总神经被切断端侧吻合于胫神经后,再生的腓总神经纤维的来源。【方法】将大鼠腓总神经切断,将其远端与胫神经施行端侧吻合,存活24个月后,再次手术暴露并将HRP(辣根过氧化物酶)注入远段腓总神经干内,72h后取大鼠脊髓L3-6节段和L4、L5脊神经节冰冻切片,用四甲基联苯胺显色显示神经细胞;并取腓总神经远段、腓总神经近段中部行电镜观察神经纤维超微结构,正常腓总神经作对照。【结果】模型鼠远段腓总神经再生神经纤维清晰、明显,神经纤维略细;脊髓L3-6节段双侧灰质前角和双侧L4、L5脊神经节均见到蓝染细胞,均以手术侧为少;腓总神经近段与正常腓总神经比较无差异、未见华勒变迹象。【结论】断裂腓总神经端侧吻合于胫神经,再生神经纤维不支持因腓总神经近段溃变轴突退缩形成生长锥引导所致,来源于胫神经可能性大。[Objective] This study was conducted to explore the origin of the regenerating axons which grow into peroneal nerve after end-to-side neurorrhaphy to tibial nerve. [Methods] The right peroneal nerve of Wistar rats was resected, and the distal nerve stumps were sutured to the epineurium windows,opened by removing the epineural sheath on the intact tibial nerve trunk. Twenty-four months after surgery, HRP was injected into peroneal nerve trunks of both sides. At 72 h after injection, the distal segment of peroneal nerves, and the middle section of proximal peroneal nerve segment were removed and superthin section were observed by electronic microscopy. The spinal cord L3-6 and spinal ganglions L4, L5 were cut 40 μm, 30 μm respectively and stained by TMB method. [Results] There were correspondent regenerating axons in the distal peroneal nerve segment, no signs of Wallerian degeneration were found in proximal peroneal segment, meanwhile in both anterior horus of spinal cord L3-6 and L4, L5 spinal ganglions of both sides, a numerous of neurons were found stained blue,in spite of a fewer in operate one. [ Conclusion ] The regenerating of nerve fibers in sutured peroneal nerve end-to-side to tibial nerve is not based on the degeneration of proximal peroneal nerve, and suggesting that the regenerating axons may be not derived from the growth cone of the injured peroneal nerve.

关 键 词：外周神经 神经再生 端侧吻合 HRP 辣根过氧化物酶 

分 类 号：R651.3[医药卫生—外科学]