经皮电刺激对大鼠周围神经端侧吻合效果的影响  

Promoting effect of percutaneous electrical stimulation on nerve regeneration after end-to-side neurorrhaphy in rats

作　　者：孙乾[1] 曹群华[1] 祝伟[1] 梅远东[1] 顾晨[1] 

机构地区：[1]常熟市第二人民医院手足外科,江苏常熟215500

出　　处：《中国比较医学杂志》2017年第12期73-78,共6页Chinese Journal of Comparative Medicine

基　　金：常熟市科技计划项目任务书(csws201302)

摘　　要：目的观察和探索经皮电刺激促进神经端侧吻合后神经再生的效果及其临床价值。方法选取雄性SD大鼠32只,随机分为正常对照组(A组),肌皮神经损伤后端端吻合至尺神经组(B组),肌皮神经损伤后端侧吻合至尺神经组(C组),肌皮神经损伤后端侧吻合至尺神经+术后经皮电刺激组(D组)。观察各组大鼠患侧肢体的肌力恢复情况以及神经纤维的再生情况。结果 C组和D组大鼠振幅、传导速度低于A组,潜伏期高于A组;而D组大鼠振幅、传导速度低于C组,潜伏期高于C组;B、C、D三组大鼠肱二头肌湿重比以及肌纤维横截面积均低于A组,且C组肌肉恢复最差;B、C、D三组大鼠NF-200表达明显低于A组,D组NF-200表达明显强于C组,但仍显著少于B组,差异均具有显著性(P<0.05)。电镜检查显示B组神经纤维髓鞘成熟,C组以无髓神经纤维为主,髓鞘成熟度差。D组髓鞘增生情况较C组好转,但仍有部分无髓神经纤维存在。结论神经端侧吻合术后经皮电刺激能有效促进神经轴突再生以及延缓靶肌的失神经萎缩,尽管较之神经端端吻合存在差距,仍不失为临床修复周围神经损伤的有效方法之一。Objective To observe and explore the effect and clinical value of percutaneous electrical stimulation on nerve regeneration after end-to-side neurorrhaphy in rats. Methods Thirty-two SPF male S-D rats were randomly divided into four groups（ n = 8） ： group A,the normal control group; group B,with end to end neurorrhaphy of musculocutaneous nerve injury matched to the ulnar nerve; group C,with end to side neurorrhaphy of musculocutaneous nerve injury matched to the ulnar group; and group D,with end to side neurorrhaphy of musculocutaneous nerve injury matched to the ulnar nerve plus postoperative transcutaneous electrical stimulation（ 30 min per day for 6 weeks）.Electromyography,postoperational nerve conduction velocity,the histological and ultrastructural changes of the nerve fibers were examined,and NF-200 expression in frozen sections was observed using imunohistological staining,to assess the recovery of muscle strength of the diseased side limb and the neuroregeneration in the rats after treatment. Results The amplitude and conduction velocity of the groups C and D were lower than that of the group A,the latency was higher than that of the group A,while the amplitude and conduction velocity of the group D were lower than that of the group C,and the latency was higher than that of the group C. The wet weight ratio of the biceps brachii muscle and the crosssectional area of muscle fibers in the groups B,C and D were lower than those in the group A,and the recovery of muscle in the group C was the worst. The expression of NF-200 in the rats of groups B,C and D was significantly lower than that in the group A,and the expression of NF-200 in the group D was significantly higher than that in the group C,but still significantly less than that in the group B（ P 0. 05）. Electron microscopy showed mature myelinated fibers in the group B,whereas unmyelinated fibers were the main component and the myelin sheath was poorly developed in the group C. The myelin regeneration in the group D was better than that i

关 键 词：电刺激 端侧缝合 神经 

分 类 号：R-33[医药卫生]