幼年大鼠神经根不同时间移植修复对神经元的影响  

Study of the neuronal effect after nerve grafting to reconstruct nerve root at different time interval in young rats

作　　者：傅阳[1] 陈亮[2] 顾玉东[2] 

机构地区：[1]复旦大学附属中山医院青浦分院骨科,上海201700 [2]复旦大学附属华山医院手外科

出　　处：《中华显微外科杂志》2013年第3期253-256,共4页Chinese Journal of Microsurgery

基　　金：国家重点基础研究发展计划（973项目,2003CB551305）

摘　　要：目的研究不同时间神经移植术修复幼年大鼠臂丛损伤后对近端神经元的影响。方法从2009年1月至12月，将出生18dSD大鼠48只随机等分为8组：第5颈神经（简称颈5）切断组、立即修复组及3、6、9、12、15、18d修复组。采用Trueblue注射法逆行标记神经元。颈5切断组将右侧颈5神经根切除0．3cm；立即修复组将颈5神经根切除后取腓肠神经行移植修复。其余各组分别在颈5切断后问隔相应时问修复。术后4周，取颈5脊髓前角和背根神经节，比较各组神经元存活数量的差异。结果幼年大鼠颈5切断后，3、6d修复组与立即修复组近端神经元计数结果的差异无统计学意义（均为P〉0．05），上述l二组神经元数量较颈5切断组显著增多（P〈0．05）。与立即修复组相比，9d修复组近端感觉神经元数量明显减少（P〈0．05），但运动神经元数量差异无统计学意义（P〉0．05）。颈5切断组和15、18d修复组近端神经元数量的差异无统计学意义（P〉0．05）。结论幼年大鼠神经根损伤后，在0～9d（相当于人类0～6个月）内修复对近端神经元可产生较满意的保护作用。这提示临床上对有手术指征的产瘫应争取在卅生后6个月内手术。Objective To disclose the relationship of neuronal protective effect and dift^rent time interval after nerve grafting reconstructed C5 root resection in young rats. Methods Mode] of C5 resection was set up in 18-day-old SD rats from Jauary 2009 to December 2009. Forty-eight rats with Cs resection were randomly divided into C5 resection group, immediate repairing group, three days delayed repairing group, and 6, 9, 12, 15, 18 days delayed repairing groups. Each group experienced nerve grafting bridged the C5 nerve root defection at its time interval. At 4 weeks postoperatively, the numbers of True Blue positively labeled neurons in all groups were counted respectively. Results There was no statistical difference among the number of proximal neuron of immediate repairing group and those of 3, 6 days delayed repair group （P 〉 O. 05） , but compared with C5 resection group, the number of neurons was statistically higher （ P 〈 0. 05 ）. There was no statistical difference between the number of motoneurons of immediate repairing group and that of 9 days delayed repairing group（P 〉 0. 05 ）, but there was statistical difference between sensory neurons of this two groups （ P 〈 0. 05 ）. The neuron number of immediate repairing group was statistically higher than those of 12, 15, 18 days delayed repairing group（P 〈 0. 05）. Conclusion Nerve reconstruction for C5 root injury in young rats within 0-9clays （equal to 0-6 months in hmnan beings） has a satisfactory protective effect on proximal neuron. It suggests that the OBPP children who have the operation indication should undergo surgical management in 6 months ＂after their birth.

关 键 词：臂丛 神经损伤 脊髓 神经元 手术时机 

分 类 号：R6[医药卫生—外科学]