冷冻止痛的机理研究  

CHANGES IN NERVE AFTER FREEZING WITH DIFFERENT TEMPERATURES

作　　者：周林球[1] 邵振海[1] 区士欢[2] 

机构地区：[1]第一军医大学珠江医院骨科 [2]第一军医大学珠江医院病理科

出　　处：《解放军医学杂志》1992年第2期96-99,共4页Medical Journal of Chinese People's Liberation Army

摘　　要：不同温度(-20℃、-60℃、-100℃、-140℃和-180℃)冷冻家兔坐骨神经后,不同时期以HE、组化染色进行光镜,超薄切片电镜及体感诱发电位(SSEP)、感觉神经传导速度(SCV)、肌电图(EMG)等观察。结果-20℃冷冻,神经形态与功能无明显变化;-60℃冷冻,神经开始变性,传导功能丧失,但神经可以通过自身代谢修复;-100℃冷冻约半数的神经纤维发生Wallerian变性,神经修复时间延长,而神经仍能完全再生修复;-140℃与-180℃冷冻,神经立即坏死,部分基膜破坏,胶原纤维增生,神经形态与功能不能完全修复。本结果解释了临床深低温冷冻止痛效果好的原因,提示低于-140℃为冷冻止痛的最佳温度。The sciatic nerves of rabbit were frozen with different temperatures(-20℃,-60℃, -- 100℃, -140℃ and 180℃).The morphology and function of the frozen nerves were examined with light microscopy (HE stain and histochemical thiocholism method), electron microscopy, and short latency sematesthelic evoked potentials(SSEP), sensory conduction velocity(SCV), electromyo-gram(EMG) at various time intervals after freezing. It was showed that there were no changes in morphology and function of nerves after being frozen at -20C. The nerve fibers showed signs of frozen degeneration and lost their conduction function at -60℃. However, the nerves could recover in this group. About one half of the nerve fibres frozen with -100℃ showed Wallerian degeneration, and the time of repair was delayed. But still the regeneration of nerves was complete. Necrosis of nerve fibers occurred immediately after freezing with -140℃ and-180℃. There were destruction of the basement membrane and proliferation of collagen fibers. The results explained the mechanism of cryoanalgesia clinically. We believe that the temperatures lower than -140℃ are optimal for cryoanalgesia.

关 键 词：冷冻止痛 周围神经 最佳温度 

分 类 号：R454.5[医药卫生—治疗学]