目标肌肉神经分布重建对大鼠幻肢痛的影响及神经分布研究(英文)

Influence of Targeted Muscle Reinnervation on Phantom Limb Pain and Distribution of Reinnervated Nerve in Rats

目标肌肉神经分布重建技术(Targeted Muscle Reinnervation,TMR)通过对假肢的实时直觉控制提高截肢者的运动功能。然而对于TMR技术是否能减轻幻肢痛、移植神经在肌肉内如何分布等问题,目前知之甚少。本文旨在探讨TMR手术对大鼠幻肢痛的影响和术后目标肌肉内神经的再分布情况。我们利用坐骨神经横断组(SNT)作为大鼠的疼痛模型,将神经近端移植到目标肌肉中作为TMR模型,并通过大鼠行为学来评价疼痛程度。实验发现,对照组大鼠不出现自残行为,而SNT组和TMR组从手术后第二天开始出现自残行为并逐渐加重,但TMR组的自残情况明显轻于SNT组。利用Sihler’s肌内神经染色法可以在目标肌肉内观察到移植神经末端再生的细小分支。实验结果初步证明TMR技术对幻肢痛有一定的缓解作用,并且术后的神经可以在目标肌肉内重新分支分布。

Targeted muscle reinnervation (TMR) can improve amputees’ movement ability by providing simultaneous and intuitive control of artificial limbs. However, little is known about whether TMR can relieve the phantom limb pain and how intramuscular nerve branches are distributed in the targeted muscle after the operation. The purpose of this study is to investigate the effects of TMR on phantom limb pain and to explore the possibility of post-operative neuranagenesis in rats. The rat model was established by sciatic nerves transaction (SNT group) and the proximal ends of these nerves were grafted into targeted muscles (TMR group). The degree of the phantom limb pain was measured by observing the autotomy behaviors of rats. The pilot results show that rats in the sham group have no autotomy behaviors, while rats in SNT group and TMR group show typical autotomy behaviors two days after the operations and the behaviors become worse gradually. However, the TMR group show obviously less pain than the SNT group. Meanwhile, some small new branches rising from the transferred nerves could be observed in targeted muscle with the aid of Sihler’s nerve staining technique. The experimental results suggest that TMR can possibly alleviate the phantom limb pain and the transferred nerve can regenerate to innervate with the targeted muscle.