两种神经功能重建术式对大鼠后肢运动功能恢复效果的比较  

Comparison of the effect of two kinds of nerve functional reconstruction operation on the recovery of lower limb motor function in rats

作　　者：蒋孟楠 张紫珺 张乾玲 苏欢 高一凡 卢巍 杨琳[6] Jiang Mengnan;Zhang Ziju;Zhang Qianling;Su Huan;Gao Yifan;Lu Wei;Yang Lin(Zhuhai Campus of Zunyi Medical University,Zhuhai 519041,China;Children's Hospital of Chongqing Medical University,Chongqing 400016,China;Zhongshan Xiaolan People's Hospital,ZhongShan 528415,China;Sun Yat-sen Memorial Hospital,Sun Yat-sen University,Guangzhou 510120,China;Guangdong Jiangmen Chinese Medicine College,Jiangmen 529099,China;Shenzhen Institutes of Advanced Technology of the Chinese Academy of Science,Shenzhen 518055,China)

机构地区：[1]遵义医科大学珠海校区,珠海519041 [2]重庆医科大学附属儿科医院,泌尿外科,重庆400016 [3]中山市小榄人民医院,广东中山528415 [4]中山大学孙逸仙纪念医院,广州510120 [5]广东省江门中医药职业学院,江门529000 [6]中国科学院深圳先进技术研究院(深圳理工大学),广东深圳518055

出　　处：《中国临床解剖学杂志》2023年第4期428-433,共6页Chinese Journal of Clinical Anatomy

基　　金：国家自然科学基金项目(81960419,81927804,82260456);贵州省科技拔尖人才支持计划(黔教合KY字[2018]56);遵义医科大学大学生创新项目(ZHCX202006,ZHCX201920)。

摘　　要：目的比较靶向肌肉神经功能重建(targeted muscle reinnervation,TMR)和靶向神经功能替代(targeted nerve function replacement,TNFR)两种术式的疗效。方法将SD大鼠随机均分为假手术(Sham)组、单纯胫神经离断(TNT)组以及在TNT基础上建立模型TMR组和TNFR组,通过足迹分析、肌电信号(electromyography,EMG)、Sihler’s肌内神经染色评价两种手术效果。结果TNFR组胫神经指数(-12.30±4.06)略大于TMR组(-13.79±5.28);第8周TMR组和TNFR组患侧EMG幅值相较于TNT组明显增强(P<0.05),TNFR组患侧EMG幅值强于TMR组;Sihler’s肌内神经染色发现TNFR组和TMR组神经和肌萎缩程度较TNT组轻;TNFR组腓肠肌内侧头延续胫神经原有功能,相较于TMR组,其神经分支更加密集。结论TNFR术及TMR术均可延缓肌萎缩并促进运动功能重建,TNFR术的远期疗效较优于TMR术。Objective To compare the clinical efficacy of"targeted muscle reinnervation(TMR)"and"targeted nerve function replacement(TNFR)"for neurological reconstruction in patients with amputation.Methods SD rats were randomly divided into a Sham group,a simple tibial nerve dissection(TNT)group,a TMR group and a TNFR group.The two operative efficacy were evaluated by footprint blotting,electromyography(EMG),and Sihler's intramuscular nerve staining.Results(1)Analysis of the footprint blotting results showed that the tibial nerve index in the TMR group(-13.79±5.289)was slightly smaller than that in the TNFR group(-12.30±4.06).(2)at the 8th week,compared with the TNT group,the amplitude of EMG on the affected side was greater in the TMR and TNFR groups(P<0.05).The amplitude of EMG on the affected side in the TNFR group was greater than that of the TMR group.(3)Sihler's intramuscular nerve staining results showed that the degree of nerve and muscle atrophy in the TNFR and TMR groups was less severe than that in the TNT group.The medial head of the gastrocnemius muscle in the TNFR group inherited the original function of the tibial nerve,and its nerve branches were denser compared with those in the TMR group.Conclusions Both TNFR and TMR can delay muscle atrophy and promote motor function reconstruction,and the long-term efficacy of TNFR is better than that of TMR.

关 键 词：靶向肌肉神经功能重建 靶向神经功能替代 Sihler’s肌内神经染色 足迹分析法 肌电信号 

分 类 号：R343[医药卫生—基础医学]