CAJ | 학술논문

目的　研究神经再生室中周围神经修复过程各组成成份的变化过程。方法　将大鼠坐骨神经于股中部切断后分隔5 mm，用硅胶管套接。术后7、14、21、28、35、42 d在透射电镜下观察神经再生室(长5 mm，分5个节段，每节段长约1 mm)中各节段细胞的超微结构。结果　术后7 d神经再生室中主要为单核细胞、红细胞、纤维蛋白；于1 mm和5 mm处还可见到含髓样变性小体的巨噬细胞和新生的成纤维细胞；特别是在1 mm处可见雪旺细胞包裹的无髓神经纤维。术后14 d有髓、无髓神经纤维已贯穿全室，神经再生室中段已有较多的含丰富内质网的新生成纤维细胞和新生毛细血管。术后21、28、35、42 d神经再生室中各段组织皆为不同成熟程度的有髓和无髓神经纤维，并被成纤维细胞突起包裹成小束，束间有不少胶原纤维。结论　术后7 d神经再生室近端已见再生轴突，术后14 d再生的神经已贯穿全管。神经再生室中成份的变化提示，神经再生需要有利的微环境。
목적　연구신경재생실중주위신경수복과정각조성성빈적변화과정。방법　장대서좌골신경우고중부절단후분격5 mm，용규효관투접。술후7、14、21、28、35、42 d재투사전경하관찰신경재생실(장5 mm，분5개절단，매절단장약1 mm)중각절단세포적초미결구。결과　술후7 d신경재생실중주요위단핵세포、홍세포、섬유단백；우1 mm화5 mm처환가견도함수양변성소체적거서세포화신생적성섬유세포；특별시재1 mm처가견설왕세포포과적무수신경섬유。술후14 d유수、무수신경섬유이관천전실，신경재생실중단이유교다적함봉부내질망적신생성섬유세포화신생모세혈관。술후21、28、35、42 d신경재생실중각단조직개위불동성숙정도적유수화무수신경섬유，병피성섬유세포돌기포과성소속，속간유불소효원섬유。결론　술후7 d신경재생실근단이견재생축돌，술후14 d재생적신경이관천전관。신경재생실중성빈적변화제시，신경재생수요유리적미배경。
Objective　To observe the ultrastructural changes of various cell components in a nerve regeneration chamber during its regenerating process. Methods　 The sciatic nerve of the rat was transected at the mid - thigh level. Then the severed nerve was guided by a silicone tube to keep a 5 mm gap between both stumps. At various postoperative time, the tissue in the nerve regeneration chamber was taken out en bloc and cut into 1 mm which blocks for transmission electron microscopic observation. Results　At the 7th day after the operation, the dominant components were monocytes, erythrocytes and fibrin. Macrophages containing myelinoid bodies and nascent fibroblasts were seen in the proximal 1st block and distal 5th block. Especially, unmyelinated nerve fibers enveloped by Schwann cells were observed in the 1st block. At the 14th day, both myelinated and unmyelinate nerve fibers were seen through the entire nerve regeneration chamber. A lot of fibroblasts, with rich endoplasmic reticulum and renewal capillaries were found in the 2nd, 3rd, and 4th blocks at the same period. At day 28, 35, 42, nerve fibers of different maturity degree existed in all the blocks and developed into fasciculi which were wrapped by fibroblasts with interstitial collagen fibers. Conclusions　In a severed peripheral nerve, regenerating axons appeared in the proximal end of the nerve regeneration chamber at the 7th postoperative day, and reached the distal end at the 14th day. The alteration of the components suggested that the nerve regeneration chamber forms a micro - environment favorable for nerve regeneration.