CAJ | 학술논문

目的观察研究不同时间预变性神经端侧吻合的效果,探讨神经端侧吻合的最佳时机.方法将Wistar大白鼠36只随机分为6组,每组6只,右侧腓总神经切断后,近端反转结扎,预变性0、1、2、4、8、16周后,远端与胫神经外膜开窗处行端侧吻合,端侧吻合术后3个月,行双侧腓总神经、胫前肌电生理及组织学检查、胫前肌肌湿重测定、运动终板检查结果 (1)预变性0、1、2周组电生理检测动作电位恢复率、肌肉单次收缩力恢复率、强直收缩力恢复率均显著高于预变性4、8、16周组,再生神经纤维数目、肌湿重、肌纤维截面积、运动终板面积及着色均显著优于预变性4、8、16周组.(2)预变性0、1、2周组之间J各检测指标差异无统计学意义(P＞0.05),预变性4、8、16周各组之间差异有统计学意义(P＜0.05),各检测指标随时间的延长逐渐衰退.结论神经端侧吻合的最佳时机应控制在2周之内,超过4周后,神经端侧吻合的效果逐渐变差.
목적 관찰연구불동시간예변성신경단측문합적효과,탐토신경단측문합적최가시궤.방법 장Wistar대백서36지수궤분위6조,매조6지,우측비총신경절단후,근단반전결찰,예변성0、1、2、4、8、16주후,원단여경신경외막개창처행단측문합,단측문합술후3개월,행쌍측비총신경、경전기전생리급조직학검사、경전기기습중측정、운동종판검사 결과 (1)예변성0、1、2주조전생리검측동작전위회복솔、기육단차수축력회복솔、강직수축력회복솔균현저고우예변성4、8、16주조,재생신경섬유수목、기습중、기섬유절면적、운동종판면적급착색균현저우우예변성4、8、16주조.(2)예변성0、1、2주조지간J각검측지표차이무통계학의의(P＞0.05),예변성4、8、16주각조지간차이유통계학의의(P＜0.05),각검측지표수시간적연장축점쇠퇴.결론 신경단측문합적최가시궤응공제재2주지내,초과4주후,신경단측문합적효과축점변차.
Objective To study the efficacy of end-to-side neurorrhaphy of different periods after degeneration.Methods Thirty-six Wistar rats were divided into 6 groups,6 every group.The peroneal nerve was transavted,the proximal end of peroneal nerve was turned back and ligated on the right side of all the animals,and allowed to undergo predegeneration for 0,1,2,4,8,16 weeks in every group respectively.The distal end was sutured to the side of tibial nerve with perineurial window.Three months after the suture,the peroneal nerve and the tibial muscle were taken for electrophysiological and histologic exminations,and the muscle wet weight was measured.Results ( 1 ) The 0-,1- and 2-week predegeneration groups had increased electrical impulse,the muscle contractility,the number of regenerated nerve fiber,the muscle wet weight,the muscle fiber cross sectional area,the moter endplate area and color as compared with 4-,8- and 16-week predegeneration groups; (2) No significant difference was found among 0-,1- and 2-week predegeneration groups,hut there was significant difference among 4-,8- and 16-week predegeneration groups (P＜0.05 ).Conclusion The operation of end-to-side neurorrhaphy should be done within 2 weeks after nerve injury.