神经损伤(移位)时近侧分支保留对神经再生肌肉功能恢复影响的比较实验研究

The affection of reserved proximal branch of transferred nerve on nerve regeneration and muscle function restoration: an experimental study

目的探讨神经移位时保留神经干近侧分支对神经再生和肌肉功能恢复的影响。方法SD大鼠36只,随机分两组,实验组(分支保留组):在右侧副神经发出2个进入斜方肌肌支后3mm处,用特制的损伤钳,以相同挤压力度及相同时间将副神经夹成2mm的损伤段;对照组(分支切断组):副神经远侧段的处理与实验组相同,并将副神经近侧的两个分支切断。术后2、4、6周分别进行电生理、组织学和图像分析检测,比较近侧分支保留与否对神经再生、肌肉功能恢复的影响。结果神经干电位传导速度(NCV)恢复率、有髓神经纤维通过率、神经纤维轴突截面积恢复率的检测结果显示实验组恢复优于对照组,差异有统计学意义(P<0.05)。结论神经损伤(移位)时保留近侧分支有利于神经损伤修复(移位)术后神经再生和肌肉功能恢复。

Objective To explore the affection of the reserved proximal branch of transferred nerve on nerve regeneration and muscle function restoration.Methods Thirty-six SD rats were divided into two groups randomly. The proximal branch of trausferred nerve was reserved in experimental group and spinal accessory nerves were crushed on the right side distal to the 2nd branch of accessory nerve by the same micro-clamp and the same time. The control group: In addition to the same procedure on accessory nerve in the experimental group, the 2 branches of accessory nerve were transected and excised 2-3mm. After operation 2?4?6 week, the electrophysiological?histological studies and image analysis were performed to study the affection of the reserved proximal branch of transferred nerve on nerve regeneration and muscle function restoration.Results The recovery rate of nerve conduct velocity, the regeneration rate of myelinated nerve, cross-sectional areas of myelinated nerve of the experimental group were superior to those of the control group, and the difference was statistically significanctP <0.05.Conclusion Reservation of the proximal branch of the injuried transferred nerve is beneficial for the nerve regeneration and muscle function restoration.