中断神经节与尺神经联系对健侧C_7神经根移位疗效影响的实验研究  

The influence of interrupting the relationship between dorsal root ganglion and ulnar nerve on treatment outcome of contralateral C_7 nerve root transfer: an experimental study

作　　者：郑圣鼐[1] 张高孟[1] 张丽银[1] 顾玉东[1] 王涛[1] 赵新[1] 

机构地区：[1]复旦大学华山医院手外科,上海200040

出　　处：《中华手外科杂志》2003年第2期72-74,共3页Chinese Journal of Hand Surgery

基　　金：高等学校博士学科点专项科研基金资助项目 (2 0 0 0 36)

摘　　要：目的　探讨中断C7～T1背根神经节与桥接尺神经联系对健侧C7神经根移位治疗全臂丛根性撕脱伤疗效的影响。方法　将 192只SD大鼠作成全臂丛根性撕脱伤模型。实验分为 3组。A组 :将患侧尺神经远端与健侧C7神经根缝合 ,其近端与正中神经缝合。B组 :将患侧尺神经远端与健侧C7神经根缝合 ,术后 6周将其近端与正中神经缝合。C组 :将患侧尺神经远端与健侧C7神经根缝合 ,同时切断患侧C7、8T1神经根 ,术后 6周将尺神经近端与正中神经缝合。 3组又分伤后即刻、1、2、4个月 4个手术时间组 ,每组 48只。 3组分别于术后 18、3 6周检测正中神经运动动作电位 (motoractionpotential ,CMAP)波幅、有髓神经纤维数及趾浅屈肌肌湿重、肌纤维截面积和肌张力 ,并计算它们的恢复率。结果　 ( 1)损伤后早期手术 :C组大鼠各项检测指标均显著优于A、B组 (P <0 .0 1) ,而A组与B组差异不明显 (P >0 .0 5 )。 ( 2 )损伤后晚期手术 :B、C组各项检测指标均优于A组 (P <0 .0 1) ,而B组与C组之间差异无显著意义 (P >0 .0 5 )。结论　 ( 1)全臂丛根性撕脱伤早期行健侧C7神经根移位 ,中断神经节与桥接尺神经的联系 ,能显著提高健侧C7神经根移位的疗效。 ( 2 )全臂丛根性撕脱伤晚期手术时 ,因尺神经已基本自然变性 。Objective To investigate the influence on the treatment outcome of contralateral C 7 nerve root transfer for treatment of brachial plexus root avulsion injuries through interrupting the relationship between the C 7 ～ T 1 dorsal root ganglion and the bridging ulnar nerve.Methods The model of whole brachial plexus roots avulsion injuries was set up in 192 SD rats. They were divided into 3 groups. In group A, the distal end of the injured ulnar nerve was reversed and anastomosed with the contralateral C 7. The proximal end of the ulnar nerve was cut and coapted with the median nerve. In group B, the distal end of the injured ulnar nerve was anastomosed with the contralateral C 7 at the first stage. The proximal end of the ulnar nerve was coapted with the median nerve on the postoperative six weeks. In group C, the operation was similar to that in group B except the C 7, C 8 and T 1 roots at the affected side were cut at the first stage. All 3 groups were subdivided into 4 groups according to the various interval: right after operation, 1,2,4 months after operation with 48 rats in each. At 18 and 36 weeks after the first operation, the number of myelinated fibers and amplitude of motor action potential at the median nerve and the wet muscular weight, muscular fibers section area and muscular tension of the flexor digitorum superficial muscle were examined. The recovery rate of these parameters was calculated.Results At the early surgery stage after injury, all the parameters in group C were statistically remarkably superior to those in group A and B. But the differences between group A and B was not distinct. At the later surgery stage after injury, all the parameters in group C and B were statistically superior to those in group A. The differences between group C and group B showed no statistical significance. Conclusion At the early stage, interrupting the relationship between the dorsal root ganglion and the ulnar nerve could significantly improve the treatment outcome of contralateral C 7 nerve roo

关 键 词：神经节 尺神经 健侧C7神经根移位 实验 神经联系中断 全臂丛根性撕脱伤 

分 类 号：R651.3[医药卫生—外科学] R622.3[医药卫生—临床医学]