幼年大鼠C5神经根切断后不同时间移植修复对靶组织的影响  

Study of the target muscle function after nerve grafting to reconstruct C5 root resection 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》2014年第1期44-47,共4页Chinese Journal of Microsurgery

基　　金：国家重点基础研究发展计划（2003cB551305）;上海市重点专科项目（ZK2012A36）

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远端靶组织的影响. 方法 2009年1月至12月,将出生18 d SD大鼠48只随机等分为8组：第5颈神经（颈5）切断组和立即修复组及3、6、9、12、15、18 d修复组.颈5切断组将右侧颈5神经根切除0.3 cm;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切断后间隔相应时间修复.术后6周,进行肌肉功能检测,包括肌肉湿重、肌肉截面积、有髓神经纤维计数、CMAP的潜伏期及波幅,比较各组靶组织功能的差异. 结果 幼年大鼠颈5切断后,各组再生有髓神经纤维计数、肌肉湿重、肌肉截面积、CMAP波幅、CMAP潜伏期总体差异有统计学意义（P＜0.05）.立即修复后运动功能恢复效果与3、6d修复组相同,神经根切断15 d以后修复靶组织功能恢复差（P＜0.05）. 结论 幼年大鼠神经根损伤后,在0～6d（相当于人类0～4个月）内修复可以有效地恢复远端靶组织（肌肉）的功能.这提示临床上对有手术指征的产瘫应争取在出生后4个月内手术.Objective To disclose the relationship of the target muscle function and different time interval after nerve grafting reconstructed C5 root resection in young rats.Methods Model of C5 resection was set up in 48 18-day-old SD rats.The rats were randomly divided into C5 resection group,immediate repairing group,3 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 6 weeks postoperatively,electrophysiological and histochemical experiment were performed.Results There was no statistical difference among the data of CMAP amplitude and latency and weight of target muscles and number of distal myelinated fiber of immediate repairing group and those of 3,6 days delayed repair group at 6 weeks postoperatively,but compared with C5 resection group,the dates was statistically higher.There was no statistical difference between the data of C5 resection group and that of 15,18 days delayed repairing group.Conclusion Nerve reconstruction for C5 root injury in young rats within 0-6 days （equal to 0-4 months in human beings） has a satisfactory protective effect on target muscles.It suggests that the OBPP children who have the operation indication should undergo surgical management in 4 months after their birth.

关 键 词：臂丛 神经损伤 手术时机 大鼠 

分 类 号：R651.3[医药卫生—外科学]