周围神经端侧吻合后乙酰胆碱转移酶变化  

Surgically intervened collateral sprouting of peripheral nerve: The Change of Cholineacetyl transferase

作　　者：曹学诚[1] 蔡锦方[1] 

机构地区：[1]济南军区总医院骨科

出　　处：《中华显微外科杂志》1999年第3期204-206,共3页Chinese Journal of Microsurgery

摘　　要：目的建立一种测定乙酰胆碱转移酶（ＣｈＡＴ）的方法，以定量研究神经端端吻合与端侧吻合后神经再生能力。方法：实验显露大白鼠胫神经及腓神经，并在腓神经分支处以远０．５ｃｍ处切断。端侧吻合组在胫神经上行外膜开窗，造成５ｍｍ×５ｍｍ外膜缺损，然后将腓神经在此处与胫神经作端侧吻合。端端吻合组使腓神经切断后直接作端端吻合。术后１～３个月分别测定切断端以远ＣｈＡＴ活性，并在３组之间作比较，即（１）端端吻合组，（２）端侧吻合组，（３）非吻合组及正常对照组。结果端侧吻合３个月后ＣｈＡＴ活性是正常对照组的一半。组织学显示端侧吻合与端端吻合组均显示有大量有髓纤维存在。结论这些结果提示端侧吻合后具有ＣｈＡＴ活性证实神经端侧吻有可能为临床治疗神经撕脱伤及大段缺损提供一条途径。Objective To establish an assay of the choline acetyl transferase (ChAT) activity to investigate the regeneration of injured peripheral nerve,repaired end to end or end to side Method Murine sciatic and peroneal nerves were exposed and the peroneal nerve was transected at the site of 0 5cm from its ramification For the end to side neurorrhaphy,epineurotomy producing a 5×5 mm window was carried out on the tibial nerve just above the level of gastrocnemius muscle ramification The peroneal nerve stump was then anastomosed end to side to the tibial nerve window For the end to end enurorrhaphy,the peroneal stump was directly anastomosed end to end The ChAT activity was measured at the site distal to the peroneal stump at 1 to 3 months postoperatively,and the results were compared among the three groups,i e 1) end to end neurorrhaphy group,2) end to side neurorrhaphy group,3)unrepaired group,and normal controls Results The ChAT activity of end to side neurorrhaphy yielded approximately two third of the value of end to end neurorrhaphy and more than half of the value of normal controls at 3 months postoperatively The histological section of end to side and end to end anastomosed peroneal nerve demonstrated the large numbers of myelinated axons and Schwann cells at the third month Conclusion All of these results indicate that end to side neurorrhaphy is comparable to that of well performed end to end neurorrhaphy and therefore,this provides an option of surgical treatment for avulsion nerve injury and massive nerve defect

关 键 词：周围神经缺损 乙酰胆碱转移酶 腓神经 

分 类 号：R651.3[医药卫生—外科学]