不同手术方法对动眼神经功能修复的影响  

Effect of different operation methods on oculomotor nerve functional recovery

作　　者：刘宁涛[1] 潘庆刚[1] 李世亭[2] 黄晓松[1] 王飞[1] 管宇航[1] 

机构地区：[1]同济大学附属同济医院神经外科,上海200065 [2]上海交通大学附属新华医院神经外科,上海200092

出　　处：《同济大学学报（医学版）》2009年第1期27-31,共5页Journal of Tongji University(Medical Science)

基　　金：国家自然科学基金资助项目(30000170)

摘　　要：目的研究不同手术修复方法对大鼠动眼神经损伤后功能重建的影响与机制。方法健康成年SD大鼠35只,随机分4组,其中正常对照组(5只)动眼神经不损伤,其余30只均分为3组,在动眼神经海绵窦段将动眼神经锐性切断后分别将断端用羊肠线缝合、生物胶粘合、血凝块粘合修复神经,术后动态观察神经功能恢复情况并进行动眼神经系统解剖学、神经组织学研究。结果以血凝块粘合和直接缝合神经断端实验组大鼠术后眼外肌功能恢复程度均优于生物胶粘合组大鼠,前两组实验大鼠支配眼外肌的中脑躯体运动神经元、新生神经纤维总数量明显多于后者,且前两个组实验大鼠新生神经纤维对上直肌特异性支配优于后者。结论以直接缝合和血凝块粘合神经断端的手术方法优于生物胶粘合神经断端的方法,关键因素是两断端对齐并稳定固定,减少吻合口疤痕组织形成,进入靶器官新生神经纤维数量以及对靶器官特异性支配的情况决定神经功能恢复程度。Objective To study the effects of different operation methods on oculomotor nerve functional recovery and nerve regeneration in rats. Methods Thirty-five male Sprague Dawley （SD） rats were randomly divided into 4 groups. The oculomotor nerves were dissected in cavemous sinus and repaired the lesioned nerve by sutering, fibrin glue .adhering, fixing up the nerve stump with plasma clot, while 5 rats without injury were kept as normal control group. The anatomy and histology of the oculomotor nerve were studied after operation and the functional recovery of the regenerated nerve was observed. Results The functional recovery in the groups which the nerve stumps sutured and adhered with plasma clot were better than the groups with nerve stumps adhered with fibrin glue. In the former two groups, the number of somatic motility neurons in diencephalon was more than that in the latter one, and the function of regenerating nerve innervating superior rectus muscle organized well. Conclusion Probably the methods which approached the nerve stumps by suturing and plasma clot were better than the method adhering the nerve stumps with glue fibrin, the key factor affecting the functional recovery was the stability between the adhering nerve stumps, and decreasing the scar of it. The degree of the functional recovery was determined by well organized regenerating nerve reinnervating the extraocular muscle.

关 键 词：动眼神经 损伤 再生 大鼠 

分 类 号：R651[医药卫生—外科学]