周围神经端侧吻合的时限研究  

End-to-side neurorrhaphy of different periods after degeneration

作　　者：杨家辉[1] 洪光祥[2] 渠刚[1] 陈振兵[2] 苏森[1] 王发斌[2] 

机构地区：[1]解放军161医院手外科,武汉430010 [2]华中科技大学同济医学院附属协和医院手外科

出　　处：《中华实验外科杂志》2012年第7期1282-1284,共3页Chinese Journal of Experimental Surgery

摘　　要：目的观察研究不同时间预变性神经端侧吻合的效果，探讨神经端侧吻合的最佳时机。方法将Wistar大白鼠36只随机分为6组，每组6只，右侧腓总神经切断后，近端反转结扎，预变性0、1、2、4、8、16周后，远端与胫神经外膜开窗处行端侧吻合。端侧吻合术后3个月，行双侧腓总神经、胫前肌电生理及组织学检查、胫前肌肌湿重测定、运动终板检查。结果（1）预变性0、1、2周组电生理检测动作电位恢复率、肌肉单次收缩力恢复率、强直收缩力恢复率均显著高于预变性4、8、16周组，再生神经纤维数目、肌湿重、肌纤维截面积、运动终板面积及着色均显著优于预变性4、8、16周组。（2）预变性0、1、2周组之间各检测指标差异无统计学意义（P〉0．05），预变性4、8、16周各组之间差异有统计学意义（P〈0．05），各检测指标随时间的延长逐渐衰退。结论神经端侧吻合的最佳时机应控制在2周之内，超过4周后．神经端侧吻合的效果逐渐变差。Objective To study the efficacy of end-to-side neurorrhaphy of different periods after degeneration. Methods Thirty-six Wistar rats were divided into 6 groups, 6 every group. The peroneal nerve was transacted, the proximal end of peroneal nerve was turned back and ligated on the right side of all the animals, and allowed to undergo predegeneration for 0, 1,2, 4, 8, 16 weeks in every group respec- tively. The distal end was sutured to the side of tibial nerve with perineurial window. Three months after the suture, the peroneal nerve and the tibial muscle were taken for electrophysiological and histologic exmi- nations, and the muscle wet weight was measured. Results （ 1 ） The 0-, 1 - and 2-week predegeneration groups had increased electrical impulse, the muscle contractility, the number Of regenerated nerve fiber, the muscle wet weight, the muscle fiber cross sectional area, the moter endplate area and color as compared with 4-, 8- and 16-week predegeneration groups; （2） No significant difference was found among 0-, 1- and 2-week predegeneration groups, but there was significant difference among 4-, 8- and 16-week predegener- ation groups （P 〈 0.05 ）. Conclusion The operation of end-to-side neurorrhaphy should be done within 2 weeks after nerve injury.

关 键 词：神经 端侧吻合 肌肉 运动终板 

分 类 号：R651.3[医药卫生—外科学]