脉冲射频和射频热凝术对臂丛神经损伤的病理学观察  

Morphology of Brachial Plexus Nerve after Pulsed Radiofrequency and Radiofrequency Thermocoagulation in Rats

作　　者：公维义[1] 苏建生[1] 陈华[1] 范崇玖[1] 张良成[1] 

机构地区：[1]福建医科大学附属协和医院麻醉科,福建福州市350001

出　　处：《中国康复理论与实践》2011年第11期1003-1006,共4页Chinese Journal of Rehabilitation Theory and Practice

摘　　要：目的探讨脉冲射频和射频热凝术致神经损伤的病理变化。方法 55只Wistar雄性大鼠,5只为正常对照组(C组),另50只暴露臂丛神经后随机分为脉冲射频组和射频热凝组,每组25只。在术后即刻、1、7、14和28 d取臂丛神行HE染色及透射电镜观察。结果脉冲射频组术后神经功能正常,光镜下可见神经纤维间出现水肿,于术后1 d最重,随后逐渐恢复。电镜下可见髓鞘板层结构松散,并有髓鞘球形成,及超微结构的代偿性增生,并逐渐恢复。射频热凝组术后神经功能消失,并出现自噬行为,镜下表现为沃勒变性和神经再生等改变。结论脉冲射频和射频热凝术对神经均可产生损伤。脉冲射频损伤轻微,且恢复快;射频热凝术则损伤严重,毁损神经恢复慢。Objective To investigate the changes of morphology of injured nerve after pulsed radiofrequency（PRF） and radiofrequency thermocoagulation（RFTC） on rats.Methods 55 male Wistar rats were selected,in which 5 were allocated to control group（group C） and the other 50 were randomly divided into group PRF（n=25） and group RFTC（n=25）.The specimens were analyzed both with light microscopy and electron microscopy at immediate,and 1,7,14 and 28 d after operation.Results In group PRF,the nerve function of rats maintained after operation.The edema among nerve fibers was found under light microscope,while myelin lamellar structure disorder and myelin balls shaped,and compensatory hyperplasia of ultrastructure under electron microscopic level.Those effects were more pronounced 1 d after operation.In group RFTC,the nerve function of rats disappeared and autophagy behaviors happened,meanwhile Waller＇s degeneration and nerve regeneration appeared under both light microscopy and electron microscopy.Conclusion PRF and RFTC can produce destruction of nerve,but PRF was minor and recoverable.

关 键 词：脉冲射频 射频热凝术 形态学 臂丛神经 

分 类 号：R741.02[医药卫生—神经病学与精神病学]