周围神经适应缓慢牵伸的机理研究兔胫后神经血循环观察  

A Study on the Adaptive Mechanism of Peripheral Nerve toGradual Limb Lengthening in Rabbits:Observation of Blood Supply

作　　者：许建中[1,2] 李起鸿[1,2] 廖维宏 

机构地区：[1]第三军医大学西南医院骨科 [2]第三军医大学野战外科研究所三室

出　　处：《中华骨科杂志》1999年第3期170-173,共4页Chinese Journal of Orthopaedics

摘　　要：目的动物活体测试表明急性牵伸周围神经６％～８％时血供明显减少，１２％～１５％时血流停滞。但缓慢牵伸肢体延长时，延长幅度可远远超过周围神经的生理弹性限度而无神经功能受损。本课题研究缓慢牵伸肢体延长对兔胫后神经血循环的影响。方法采用兔后肢延长模型，按胫骨延长幅度分为１０％、２０％、３０％及４０％四组，２４只用于墨汁灌注胫后神经血管形态观察。２２只用于氢气清除法胫后神经血流量测定。结果随着肢体延长量的增加，胫后神经血管逐渐变直，但血管密度及面积明显增加。图像分析显示延长区及其远、近端的血管面积均明显大于健侧对照。切片观察束内毛细血管充盈良好。氢气清除法血流量测定不同延长组间及与正常对照组间差异无统计学意义。结论周围神经的血循环逐渐适应缓慢的牵张应力，从而使之在肢体延长的过程中避免缺血性损害，为神经的再生修复提供血供保障。Objective To evaluate the effect of limb lengthening on the blood circulation of posteriortibial nerve in rabbits. Methods The tibial lengthening operation was performed in rabbit and created as thegradual stretching model of 10% , 20% , 30% and 40% . Twenty-four animals were used for the morphologicalobservation of blood vessels in the posterior tibial nerve by filling of Chinese ink, and 22 for the determinationof regional blood flow by Hydrogen clearance method(HCM) . Results it was found that, as lengtheningproceeded, that the waved shape of blood vessels was straightened, both the transverse and oblique branchbecame parallel to the nerve trunk, the density and diameter of the blood vessels were increased. Image analysisindicated that the distribution of blood vessels in proximal, lengthened and distal parts of posterior tibial nervewere all higher than that of normal control. Pathological section also revealed that the endoneurial capillary waswell filled. The blood flow rate by HCM in different lengthening groups has no significant difference comparedwith normal control. Conclusion The results demonstrated that the blood circulation of peripheral nerve couldadapt to the gradual tension force, so that ischemic damage might be avoided during limb lengthening. On theother hand, the synchronous regeneration of peripheral nerve is provided by rich blood supply.[

关 键 词：骨延长术 周围神经 血循环 血流动力学 

分 类 号：R687.35[医药卫生—骨科学]