神经“借干”修复周围神经缺损的实验研究  

Experimental study of repairing peripheral nerve defects using bridging neurons

作　　者：张子清[1] 李保龙[1] 刘良燚[1] 杨延军[1] 曹爱兵[1] 劳杰[2] 顾玉东[2] 

机构地区：[1]广东省深圳市龙岗中心医院手外科专科医院,深圳518116 [2]复旦大学附属华山医院手外科,上海

出　　处：《中华手外科杂志》2013年第5期308-311,共4页Chinese Journal of Hand Surgery

基　　金：卫生部手功能重建重点实验室课题资助项目（2010）上海市周围神经显微外科重点实验室课题资助项目（08DZ2270600）

摘　　要：目的探讨周围神经缺损的修复方法。方法取sD雄性大鼠54只，切取右侧腓总神经10mm，建立大鼠腓总神经缺损模型，随机分为3组，每组18只。A组为神经“借干”修复组，将腓总神经的远、近断端均修剪成45°斜面，在胫神经干相应外膜上开窗，分别行神经外膜端侧缝合；B组为远断端端侧缝合组，将腓总神经的近端结扎并翻转缝于邻近肌肉内，将腓总神经远断端修剪成45°斜面，相应胫神经干外膜开窗，行端侧缝合；C组为自体神经回植组（对照组），将切取的腓总神经原位回植。术后20周，对各组大鼠进行神经电生理和病理组织学检测。结果术后20周，A组的神经传导速度、胫前肌复合动作电位、有髓神经纤维计数均优于B组（P〈0．05），与C组比较差异无统计学意义（P〉0．05）。结论对于大鼠周围神经缺损，神经“借干”修复方法是可行的。Objective To explore a novel method repairing peripheral nerve defects. Methods A nerve defect model was created by removing a 10 mm segment of the right common peroneal nerve in 54 male SD rats. These rats were randomly divided into three groups with 18 rats each. Animals in group A, the neuron- bridging repair group, were subject to the following steps： trimming the proximal and distal ends of the common peroneal nerve into a 45 ° bevel; opening a window in the epineurium of the adjacent tibial nerve; and suturing the peroneal nerve ends to the tibial nerve in an end-to-side fashion. In group B, the proximal peroneal nerve end was ligated, turned around and sewn into the adjacent muscle, while the distal peroneal nerve end was trimmed into a 45 ° bevel and sewn to an epineurium window on the tibial nerve in an end-to-side fashion. Group C was the autologous nerve graft group（control group）, in which the cut peroneal nerve segment was sutured back in situ. Electrophysiology, transmission electron microscopy and tolnidine blue staining of nerve sections were done 20 weeks after the operation. Results Nerve conduction velocity, compound mnscle action potential amplitude and myelinated nerve fiber density in group A were significantly higher than those in group B 20 weeks postoperatively （ P 〈 0.05）, but not significantly different from those in group C（ P 〉 O. 05）. Conclusion It is feasible to repair peripheral nerve defects in rats by using bridging neurons.

关 键 词：周围神经 动物实验 神经缺损 端侧缝合 神经借干 

分 类 号：R651.3[医药卫生—外科学]