大鼠股神经结扎损伤修复方法的实验研究  

EXPERIMENTAL STUDY ON THREE REPAIRING METHODS FOR FEMORAL NERVE INJURY AFTER LIGATION IN RATS

作　　者：杨加富[1,2] 张晨[1] 孙琳[1] 王志军[1] 付雷[3] 

机构地区：[1]大连大学附属新华医院整形外科,辽宁大连116021 [2]四川米兰美容外科医院整形外科 [3]大连医科大学基础医学院机能实验室

出　　处：《中国修复重建外科杂志》2012年第7期837-844,共8页Chinese Journal of Reparative and Reconstructive Surgery

摘　　要：目的探讨股神经结扎后不同时期,分别采用缝线解除、缝线解除加神经外膜松解和结扎处股神经切除后吻合3种方法修复后的效果,为临床上修复医源性周围神经结扎损伤提供参考。方法健康成年SD雌性大鼠120只,体重(200±20)g,制备左侧股神经结扎动物模型后随机分为3组,每组40只。A组为缝线解除组,B组为缝线解除加神经外膜松解组,C组为结扎处股神经切除后吻合组;每组根据对股神经修复时间不同分为即时修复(0期)和1、3、5个月修复(分别为1、2、3期),每期各10只。每期修复术后3个月,检测大鼠运动功能(足基角、跟尾角)、神经电生理(股神经动作电位和传导速度)、股四头肌湿重,取股四头肌和股神经行组织学观察并计数肌纤维数量和神经纤维通过率。结果足基角:在0、1、2、3期,A组均显著低于C组(P<0.05),A、B组间差异均无统计学意义(P>0.05)。跟尾角:在0、1、2、3期,A组均显著低于C组(P<0.05);在1、2、3期,B组均显著低于C组(P<0.05)。股四头肌湿重:除1期外,B组均显著大于C组,差异有统计学意义(P<0.05);在0、2期,A组均显著大于C组(P<0.05);除3期A组显著小于B组(P<0.05)外,其余各期A、B组间比较差异均无统计学意义(P>0.05)。股神经动作电位:在0、1期,A组与B、C组比较,差异均有统计学意义(P<0.05);在2、3期,除3期A组显著高于C组(P<0.05)外,其余各组间比较差异均无统计学意义(P>0.05)。股神经传导速度:在0、1、3期,A组均显著高于C组(P<0.05);在0、1期A组均显著高于B组(P<0.05),在1、2期A、B组间比较差异无统计学意义(P>0.05);B组仅0期显著高于C组(P<0.05)。股四头肌肌纤维计数:在1、2期各组间差异均无统计学意义(P>0.05);在0期,A、B组均显著高于C组(P<0.05);在3期,A组显著高于B组(P<0.05)。股神经纤维通过率:除2期A组较B、C组增加(P<0.05)外,其余各期各组间比较差异均无统计学意义(P>0.05)。结论股神经结�Objective To investigate the effects of 3 methods （suture removal, suture removal with epineurium neurolysis, and ligated femoral nerve resection with end-end suture） in repairing femoral nerve injury after ligation in different periods so as to provide a reference for clinical use of repairing iatrogenic ligation injury of the peripheral nerve. Methods A total of 120 adult female Sprague Dawley rats, weighing （200 ± 20） g, were used to prepare the animal models of left femoral nerve ligation, and were divided into groups A （n=40）, B （n=40）, and C （n=40） according different repairing methods. At immediate, 1, 3, and 5 months （10 rats each time point） after ligation, suture removal was performed in group A, suture removal with epineurium neurolysis in group B, and ligated femoral nerve resection with end-end suture in group C. At 3 months after operation, the foot-base angle （FBA） and the heels-tail angle （HTA）, action potential and conduction velocity of femoral nerve, and wet weight of quadriceps femoris muscle （QFM） were measured; the samples of quadriceps femoris and femoral nerve were harvested for histological observation, muscle fiber count, and nerve fiber passing rate measuring. Results The FBA in group A was significant smaller than that in group C at immediate, 1, 3, and 5 months （P 〈 0.05）, but there was no significant difference between groups A and B （P 〉 0.05）. The HTA in group A was significantly smaller than that in group C at immediate, 1, 3, and 5 months （P 〈 0.05）, and the THA in group B was significantly smaller than that in group C at 1, 3, and 5 months （P 〈 0.05）. The wet weight of QFM in group B was significantly higher than that in group C at immediate, 3, and 5 months （P 〈 0.05）, and the wet weight of QFM in group A was significantly higher than that in group C at immediate and 3 months （P 〈 0.05）, but no significant difference was found between groups A and B at immediate, 1, and 3 months （P 〉 0.05）. There was

关 键 词：股神经 结扎损伤 神经修复 大鼠 

分 类 号：R651.3[医药卫生—外科学]