周围神经减压、维生素B1和功能训练对改善大鼠周围神经卡压的影响  

Effects of peripheral nerve decompression,vitamin B1 and functional training on improving peripheral nerve entrapment in rats

作　　者：王立波[1] 刘彦群 初海坤[3] 王暖凤[4] 徐衍斌[5] 孙智颖[6] 郭艳启[3] Wang Libo;Liu Yanqun;Chu Haikun;Wang Nuanfeng;Xu Yanbin;Sun Zhiying;Guo Yanqi(Department of Hand Surgery,Daqing Longnan Hospital,Daqing 163000,China;Department of Orthopedics,Surgery Teaching and Research Office,Trauma Center,Affiliated Hospital of Yanbian University,Yanji 133099,China;Department of Orthopedics,Daqing Oilfield General Hospital,Daqing 163000,China;Department of Rheumatology,Daqing oilfield General Hospital,Daqing 163000,China;Department of Spine and Joint Surgery,Siping Fourth People's Hospital,Siping 136099,China;Electromyography Room,Daqing Oilfield General Hospital,Daqing 163000,China)

机构地区：[1]大庆龙南医院手外科,大庆163000 [2]延边大学附属医院骨科诊疗中心、外科教研室、创伤中心,延吉133099 [3]大庆油田总医院骨科,大庆163000 [4]大庆油田总医院风湿科,大庆163000 [5]四平市第四人民医院脊柱关节外科,四平136099 [6]大庆油田总医院肌电室,大庆163000

出　　处：《中华手外科杂志》2023年第1期68-72,共5页Chinese Journal of Hand Surgery

摘　　要：目的探讨周围神经减压术腹腔注射维生素BI及功能训练对改善大鼠周围神经卡压的作用效果。方法采用经典Mackinnon大鼠坐骨神经卡压模型建立动物模型,将80只成年大鼠分为4组:A组(对照组)20只Mackinnon大鼠坐骨神经卡压模型组;B组20只坐骨神经卡压建模后行周围神经卡压外膜松解术;C组20只坐骨神经卡压建模后行周围神经卡压外膜松解术并按30 mg/kg维生素B1量腹腔注射给药,其他组注入相同剂量的生理盐水;D组20只坐骨神经卡压建模后行周围神经卡压外膜松解术并同步进行功能康复训练。比较组间坐骨神经功能指数(sciatic function index.,SFI)、坐骨神经透射电镜相关参数、炎症因子、血液流变学相关参数的差异性。结果A组SFI(-100.30±6.11)低于B组(-36.25±2.95)、C组,(-15.65±2.60)、D组(-36.00±2.62),而C组高于B、D组,差异均有统计学意义(P<0.05)。A组神经传导速度(15.05±2.11)m/s低于B组(31.50±1.96)m/s.C组(50.00±3.21)m/s、D组(29.30±2.36)m/s(P<0.05),且C组高于B、D组,差异均有统计学意义(P<0.05)。B、C、D组三头肌重量髓鞘厚度、神经纤维直径高于A组,且C组高于B、D组,差异均有统计学意义(P<0.05)。B、C、D组的TNF-α、IL-6、CRP水平低于A组,且C组低于B、D组,差异均有统计学意义(P<0.05)。B、C、D组的全血粘度高切、全血粘度低切、血液粘度、红细胞压积水平低于A组,且C组低于B、D组,差异均有统计学意义(P<0.05)。C组的GAP43、VEGF水平高于A组,B、D组的VEGF水平高于A组,差异均有统计学意义(P<0.05)。结论周围神经减压术通过增加坐骨神经中与血管及神经再生相关的VEGF及GAP-43表达,阻碍周围神经被进一步破坏的趋势,对周围神经功能具有保护作用。Objective To investigate the effect of peripheral nerve decompression,intraperitoneal administration of vitamin B1 and functional training on improving peripheral nerve entrapment in rats.Methods The classical Mackinnon rat sciatic nerve compression model was used to establish the animal model.Eighty adult rats were divided into 4 groups.The group A was control group,20 Mackinnon rats with sciatic nerve entrapment model.In group B,20 rats were performed with peripheral nerve entrapment and epineural release after modeling.In group C,20 sciatic nerve entrapment models were established,then epineural release was conducted,and 30 mg/kg vitamin BI was injected intraperitoneally.The other groups were injected with the same dose of physiological saline.In group D,20 sciatic nerve entrapment models were established,then epineural release and functional rehabilitation training were conducted.The differences of sciatic function index(SFI),parameters related to transmission electron microscopy of sciatic nerve,inflammatory factors and hemorheology between groups were compared.Results The SFI of group A(-100.30+6.11)was significantly lower than that of group B(-36.25±2.95),groupC(-15.65±2.60)and group D(-36.00±2.62),while that of group C was significantly higher than that of group B and D(P<0.05).The nerve conduction velocity in group A(15.05±2.11)m/s was significantly lower than that in group B(31.50±1.96)m/s,group C(50.00±3.21)m/s,and group D(29.30±2.36)m/s,and group C was higher than that in group B and D,and the difference was statistically significant(P<0.05).The weight of triceps,thickness of myelin sheath and diameter of nerve fiber in group B,C and D were higher than those in group A,and those in group C were higher than those in group B and D,and the difference was statistically significant(P<0.05).The levels ol TNF-α,IL6 and CRP in group B,C and D were lower than those in groupA,and group C was lower than that in group B and D,and the difference was statistically significant(P<0.05).The levels of whole blo

关 键 词：动物实验 大鼠 周围神经卡压 神经减压术 维生素B1 

分 类 号：R651.3[医药卫生—外科学]