周围神经延长后单根神经纤维的组织学观察  

Histological observation of single nerve fiber after peripheral nerve stretching

作　　者：闫家智[1] 姜保国[1] 徐海林[1] 张宏波[1] 李剑[1] 张培训[1] 魏光如[1] 赵富强[1] 

机构地区：[1]北京大学人民医院创伤骨科,100044

出　　处：《中华手外科杂志》2004年第1期58-60,共3页Chinese Journal of Hand Surgery

摘　　要：目的　观察周围神经延长后单根神经纤维的组织学改变并探讨其组织学基础。方法　按神经牵张程度不同分为正常对照组 (G1)、神经即刻延长 10 %组 (G2 )、神经即刻延长 2 0 %组 (G3 ) 3组。利用单根神经纤维剥离研究法 ,观察离体家兔腓神经延长后单根神经纤维的结间体长度及郎飞结、施 兰切迹等组织学变化。结果　G1组神经结间体平均长度为 114 9.2 2 μm ;G2组为 12 48.0 6μm ,较G1组延长了8.61% (t=4.66,P <0 .0 1) ;G3组为 13 17.2 4μm ,较G1组延长了 14 .6% (t=6.48,P <0 .0 1)。G3组和G2组结间体平均长度相比差异有非常显著意义 (t =10 .69,P <0 .0 1)。G2组和G3组朗飞结、施 兰切迹较G1组明显增宽 ,G3组单根纤维在朗飞结处有断裂。结论　当神经干延长到 10 %时 ,主要靠结间体的延长来适应 ,朗飞结、施 兰切迹已经明显增宽。当神经干延长到 2 0 %时 ,结间体已经延长到极限 ,朗飞结已经有断裂 ,尽管外观仍完整 。ObjectiveTo observe the histological alterations of single ner ve fiber structures after nerve stretching by employing a rabbit peroneal nerve st retching model. Methods9 rabbits weighing about 3.0 kg were us ed in the experi ment. 3 rabbits were used as controls when only sham operation was done (group 1 , 0% stretch). Acute stretching of the peroneal nerves to elongate them by 10% w as done in 3 rabbits (group 2, 10% stretch) and by 20% (group 3, 20% stretch) in another 3 rabbits. All animals were evaluated by a teased-fiber study. The int e rnodal lengths were measured, and nodes of Ranvier and Schmidt-Lanterman notch w ere observed.ResultsThe nerve fiber length was increased after stretching. T he mean internodal length was 1149.22 μm in group 1, 1248.06 μm in group 2, a nd 1317.24 μm in group 3. Compared with the control group, mean internodal length w as elongated by 8.61% in group 2 and 14.6% in group 3. The difference was statis tically significant. The node of Ranvier and Schmidt-Lanterman notch was wider i n both group 2 and group 3. Rupture of nerve fiber at the node of Ranvier was ob served in group 3. ConclusionThe peroneal nerve in rabbits can adapt to mild s tretching by internodal length elongation. Elongation by 20% will cause structur al rupture and therefore is the limit for nerve stretching.

关 键 词：神经延长术 单根神经纤维 组织学 臂丛神经牵拉性损伤 周围神经医源性损伤 

分 类 号：R651.3[医药卫生—外科学]