外膜袖套吻合法修复雌性SD大白鼠坐骨神经离断的实验研究  

Experimental study of repairing transection of the female sd rats' sciatic nerve by epineurial cuff anastomosis method

作　　者：张银龙[1] 张之智[1] 胡金明[1] 卢伟[1] 李晓东[1] 赵鹏[1] 盛德岩[1] 苗巍[1] 

机构地区：[1]焦作煤业(集团)有限责任公司中央医院骨科,河南焦作454000

出　　处：《中国医学工程》2011年第10期19-21,共3页China Medical Engineering

摘　　要：目的通过动物实验,比较神经外膜袖套吻合法和神经外膜直接吻合法修复离断周围神经的效果。方法雌性成年SD大白鼠48只,随机分为两组,即神经外膜直接吻合法组(对照组)、神经外膜袖套吻合法组(实验组),每组24只。两组皆解剖出左侧坐骨神经并与中段横行离断,对照组以神经外膜直接吻合法吻合离断神经;实验组以神经外膜袖套吻合法吻合离断神经。术后4、8、12周每组各取大鼠8只,进行手术显微镜下吻合口形态、组织学观察、坐骨神经有髓纤维计数、测量腓肠肌肌肉湿重、腓肠肌最大收缩力等。并进行统计学分析。结果术后各观察时间段,对照组吻合口瘢痕组织增生,与周围组织粘连较重,有神经瘤形成;实验组吻合口处未见与周围组织明显粘连,小间隙壁轻度瘢痕化,无神经瘤形成。有髓神经纤维总数:术后12周,实验组多于对照组,两组比较p<0.05,差异有统计学意义。腓肠肌肌肉湿重:8周时,实验组重于对照组,两组比较p<0.05,差异有统计学意义。腓肠肌最大收缩力恢复率:术后12周,实验组较对照组高,两组比较p<0.05,差异有统计学意义。结论神经外膜袖套吻合法修复神经效果优于神经外膜直接吻合法。【Objective】 Through animal experiment,comparing the effect on repairing of peripheral nerve between epineurial cuff anastomosis method group and direct epineurial anastomosis method.【Methods】 48 female SD rats,randomly divided into 2 experiment groups,that is epineurial cuff anastomosis method group（experiment group）,direct epineurial anastomosis method group（control group）,each group had 24 rats.Every rats of each group were mid-thigh sciatic Nerve,transverse cut,which is in control group the broken nerve was sutured directly,in experiment group sutured by epineurial small gap anastomosis method.At 4,8,12 weeks post-op,took out 8 rats from each groups,examined the anastomotic pattern under microscope,histological observation,Myelinated fiber counts of sciatic nerve,gastrocnemius muscle wet weight gastrocnemius＇ biggest contracture,made a statistical analysis.【Results】 In all observation time,Control group,post-op,the adhesion between the anastomosis site and the surrounding tissue was severer,scar tissue proliferates,and there was neuroma formation;Experiment group,no obvious adhesion formation can be seen,mild scar tissue proliferation can be seen around the venous bridge,,and no neuroma formation.From total myelinated nerve fibers of each group：At 12 weeks,the number of Control group is bigger than Experiment group.p0.05,the difference was statistically significant.The wet weight of the gastrocnemius muscle：at 8 weeks,Experiment group is heavier,p 0.05,the difference was statistically significant.The response rate of the maximum tetanic contraction： at 12 weeks,Experiment group is heavier,p 0.05,the difference was statistically significant.【Conclusion】 the effect on repairing of peripheral nerve by Epineurial cuff anastomosis is better than by the epineurium direct anastomosis.

关 键 词：神经 袖套 吻合法 动物 实验 

分 类 号：R816.8[医药卫生—放射医学]