CAJ | 학술논문

背景：促进周围神经损伤后神经功能的恢复，一方面要尽量加快损伤处神经轴突的再生，另一方面需要提高近端与远端神经对接的精确度。目的：观察机械挤压伤与冰冻损伤2种损伤模式下周围神经损伤后神经轴突的选择性再生情况。方法：取健康8周龄雄性Sprauge-Dawley大鼠110只，分为3组，对大鼠行股神经主干夹伤、冰冻损伤或空白对照处理。造模后分别于第2，3，6，12周进行大体行为学检查，另外分别用纯蓝和荧光红标记错向长入的隐神经和正确长入的股神经肌支，逆行示踪标记运动神经元观测脊髓前角中示踪剂的分布及数目；造模后8周行电生理检查，并进行统计学分析。结果与结论：夹伤组与冰冻损伤组大鼠术侧后腿活动范围均缩小，伸腿功能均受限，但随时间的延长，功能有所恢复。股四头肌处可记录到运动诱发电位，2组之间差异无显著性意义(P>0.05)。冰冻损伤组与夹伤组在荧光显微镜下均观察到脊髓前角红染神经元逐渐增加，造模后不同时间点夹伤组红染神经元数目显著高于冰冻损伤组(P<0.05),蓝色与紫色神经元数量逐渐减少。结果提示，保持神经束膜的完整性，即使损伤范围较大也能得到轴突再生中准确对接以及损伤肢体功能的恢复。
배경：촉진주위신경손상후신경공능적회복，일방면요진량가쾌손상처신경축돌적재생，령일방면수요제고근단여원단신경대접적정학도。목적：관찰궤계제압상여빙동손상2충손상모식하주위신경손상후신경축돌적선택성재생정황。방법：취건강8주령웅성Sprauge-Dawley대서110지，분위3조，대대서행고신경주간협상、빙동손상혹공백대조처리。조모후분별우제2，3，6，12주진행대체행위학검사，령외분별용순람화형광홍표기착향장입적은신경화정학장입적고신경기지，역행시종표기운동신경원관측척수전각중시종제적분포급수목；조모후8주행전생리검사，병진행통계학분석。결과여결론：협상조여빙동손상조대서술측후퇴활동범위균축소，신퇴공능균수한，단수시간적연장，공능유소회복。고사두기처가기록도운동유발전위，2조지간차이무현저성의의(P>0.05)。빙동손상조여협상조재형광현미경하균관찰도척수전각홍염신경원축점증가，조모후불동시간점협상조홍염신경원수목현저고우빙동손상조(P<0.05),람색여자색신경원수량축점감소。결과제시，보지신경속막적완정성，즉사손상범위교대야능득도축돌재생중준학대접이급손상지체공능적회복。
BACKGROUND:In order to promote the recovery of nerve function after peripheral nerve injury, we should try to accelerate the regeneration of injured nerve axons on one hand, and try to improve the accuracy of proximal and distal nerve docking on the other hand. OBJECTIVE:To explore the selective regeneration of nerve axons after peripheral nerve injury in models with crush injury and freeze injury. METHODS:Total y 110 healthy male Sprauge-Dawley rats, 8 weeks old, were selected and randomly divided into three groups. The rates received crush injury, freeze injury and normal control ed surgery on femoral nerve trunk. At 2, 3, 6 and 12 weeks after modeling, general behavioral examination was performed, and then pure blue and red fluorescence were used to label the wrong-way ingrowth saphenous nerve and correct ingrowth femoral nerve muscular branches respectively;retrograde labeling the motor neurons in order to observe the distribution and amount of tracer in spinal cord anterior horn;electrophysiological examination was performed at 8 weeks after modeling, and analyzed statistical y. RESULTS AND CONCLUSION:Rats from both crush injury group and freeze injury group displayed decreased motion radius of hind limbs after surgery, and the stretch function was limited;but with time prolonging, the functions were recovered. The motor evoked potentials could be observed at the quadriceps, and there was no significant difference between two groups (P>0.05). The number of neurons stained red in the spinal cord anterior horn was increased gradual y in both crush injury group and the freeze injury group under fluorescence microscope. The number of neurons stained red in the crush injury group was significantly higher than that in the freeze injury group (P<0.05), and the number of blue-stained and purple-stained neurons was decreased gradual y. The results suggest that keeping the perineurium intact can gain accurate docking in axon regeneration and the recovery of injured limb functions, even though the damaged range is large.