神经端侧吻合中外膜对神经再生影响的实验研究  

The influence of the epineurial sheath in the end-to-side Neurorrhaphy--An experimental study in rats

作　　者：易西南[1] 王炎之[1] 李昌琪[1] 曾赵军[1] 伍校琼[1] 

机构地区：[1]长沙市湖南医科大学人体解剖学教研室,410078

出　　处：《中国局解手术学杂志》2000年第3期215-216,共2页

摘　　要：目的 为临床利用端一侧吻合修复周围神经缺损提供相关的实验依据。方法 采用SD大鼠,左侧胫神经干外膜开窗,将腓总神经远端端一侧吻合至胫神经干上(A组)。右侧胫神经干包饶一开窗的筋膜套管(B组)。术后15周分别用快兰(FB)和核黄(NY)标记胫神经和再生的腓总神经,观察背根神经节(DRG)的标记细胞并作吻合口处神经纤维光镜下的直视观察。结果 A组动物其背根神经节有大量快兰标记阳性细胞和核黄标记阳性细胞,但未见双标细胞,光镜下可见腓总神经内有多束再生纤维由胫神经干分枝而来。B组背根节内仅见快兰细胞,光镜下腓总神经内未见有来自胫神经的再生纤维。结论 我们认为神经外膜对端侧吻合后的侧枝再生可能有屏障作用,因而建议作神经端侧吻合时采用对供神经干外膜开窗的方式。但应考虑外膜开窗时供神经有受损的可能。Objective Supply an experimental result to the clinical doctor who uses end-to-side neurorrhaphy to repair the peripheral nerve defect. Methods 20 SD rats were treated in the study. The peroneal nerve was sectioned and the distal ending was sutured to the lateral face of the tibial nerve. Group A (n = 20), the Left tibial nerve was removed a small epineurial sheath window (d = 2mm) and the peroneal nerve was sutured to the epineurial sheath. Group B (n = 20) the right tibial nerve was embed with a piece of fascia on which a small window had left. The peroneal nerve was sutured to the fascia. After 15 weeks, the animals were subjected to retrograde fluorescent double labeling (fast blue and nuclear yellow) . The dorsal root ganglia and the nerve trunk were harvested. Results A large of cells bodies with FB and with NY were found in the dorsal root ganglia in group A, but only cell bodies with FB were obtained in group B. No double labeling cell was found in both A and B. Under light microscopy, we can observe the regenerative nerve fibers into the peroneal nerve from tibial nerve trunk in group A, but only connective tissue was obtained in group B. Conclusion It suggests that the better method for the end-to-side neurorrhaphy to open a small epineural sheath window on the donor

关 键 词：周围神经 神经端侧缝合术 逆行荧光标记 

分 类 号：R651.3[医药卫生—外科学]