大鼠坐骨神经损伤手术时机选择的实验研究  

The Timing of Surgery in Sciatic Nerve Injury Rats

作　　者：贺菊芳[1] 余资江[1] 戈果[1] 田广[1] 朱晓瓞 高帆 曹文鹏[1] 方丽丽[1] HE Jufang YU Zijiang GE Guo TIAN Guang ZHU Xiaodie GAO Fan CAO Wenpeng FANG Lili(Human Anatomy Department, Guizhou Medical University , Guiyang 550025, Guizhou, Chin)

机构地区：[1]贵州医科大学,人体解剖学教研室,贵州贵阳550025

出　　处：《贵州医科大学学报》2016年第10期1122-1127,1132,共7页Journal of Guizhou Medical University

基　　金：国家自然科学基金(81060108);贵州省科技厅2012年社会发展攻关项目[黔科合SY字(2012)3153号]

摘　　要：目的:构建大鼠坐骨神经V度损伤模型,探寻坐骨神经损伤后最佳手术缝合时机。方法:将42只成年SD大鼠随机均分为对照组、模型组、0、6、12、24及48 h缝合组,对照组仅暴露坐骨神经、模型组剪断右侧股骨段坐骨神经,0、6、12、24及48 h缝合组在剪断右侧股骨段坐骨神经后的相应时点缝合坐骨神经,各组分别于手术后第7、14、21及28天时取坐骨神经损伤段,免疫组织化学法检测血管内皮生长因子(VEGF)的表达、采用Western Blot检测VEGF蛋白表达、HE染色法观察坐骨神经轴突排列分布及髓鞘的改变、透射电镜观察突触形态结构的变化、TUNEL法检测神经细胞的凋亡,比较各组术后神经修复效果。结果:免疫组织化学结果显示,VEGF蛋白在模型组和6 h缝合组术后第7天时表达高于其他组(P<0.05);Western Blot结果显示术后第7天时6 h缝合组术后VEGF蛋白表达高于其他缝合组(P<0.05),HE染色、透射电镜及TUNEL检测结果显示,6 h缝合组与其他缝合组比较,坐骨神经形态学变异程度较小,且凋亡细胞数少。结论:坐骨神经损伤后6 h时给予缝合处理神经修复效果最好,其机制可能与VEGF表达升高有关。Objective： To establish Sciatic nerve V-grade injury rat model,and to explore the optimal surgical suture time after sciatic nerve injury. Methods： 42 adult SD rats were randomly divided into 7groups： control group,model group and 0,6,12,24,48 h suture group. The control group only exposed the sciatic nerve,the sciatic nerves of model group and 0,6,12,24,48 h suture groups were cut off on the right side of the femur,then were stitched at different time in suture groups. 7,14,21,28 d after surgery,the right sciatic nerve injury segment was taken,the healing effect was analyzed by HE staining,VEGF immunohistochemistry,VEGF Western-blot,apoptosis detection and transmission electron microscopy. Results： Immunohistochemistry and Western Blot showed that the expression of VEGF protein in 6 h suture group at 7 d after surgery were higher than other model groups（ P〈 0. 05）. HE staining,transmission electron microscopy and TUNEL test showed that morphological variation of sciatic nerve and the number of apoptotic cells in 6 h suture group was less than other model groups. Conclusion： The repair effect of 6 h suture group is better than other time suture groups,and its mechanism might be related to the increase of VEGF protein expression.

关 键 词：坐骨神经 创伤和损伤 模型 动物 血管内皮生长因子 大鼠 Sprague Dawley 手术时机 

分 类 号：R322.85[医药卫生—人体解剖和组织胚胎学]